A.N.Z. Appliance Parts - Australian Appliance Parts Suppliers

Credit Application

Please complete our online credit application form below OR download our credit application and fax it to us. A.N.Z. Appliance Parts Credit Application Form (48KB PDF). Confirmation of this credit application will be emailed to the email address(†) you enter in the form.


Company Name:*		ABN/ACN*

Owner/Proprietor:*		Driver License No.*

Postal Address:*

Delivery Address:*		Phone No.*

Email Address:* †		Fax No.

Years in Business:*		Est. Monthly Purchase:*

Accounts Person:*

Trade References*
1. Contact:			Company:



Phone No.	Fax No.	Email Address:

2. Contact:

Company



Phone No.	Fax No.	Email Address:

3. Contact:

Company



Phone No.	Fax No.	Email Address:

TRADING TERMS:
• Statements will be issued on the first day of each month.
• Full payment to be received by the last Trading day of each month.
• Monthly accounts are payable by cheque or Direct EFT payment. Please call our accounts department for EFT payment details. No Credit Cards accepted for 30 day accounts.

I accept the trading terms as set out above.
I am duly authorised to make this application

Applicant Full Name:

Application Date:

Position:

Message:

Security question: What city is the capital of Victoria?

* Denotes required information