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Account Application Form


DATE: ......./......./20.......

FAX TO: (02) 9519 2914

Business Name, Delivery & Mail Address:
BUSINESS NAME:..........................................................................................................................
DELIVERY ADDRESS: .................................................................................................................
SUBURB: ....................................................................................................................................
PHONE: ............................................... FAX: ..........................................................
SPECIAL DELIVERY INSTRUCTIONS (If Applicable).........................................................

NEAREST CROSS STREET:..................................OPENING TIMES: ............................................
MAIL ADDRESS:..........................................................................................................................
SUBURB:..................................................................................................................................
PHONE: ........................................... FAX: ....................................

Main Contact Person
REPRESENTATIVE NAME: ...........................................(Proprietor/Director/Manager/Cake orders)**
BUSINESS PHONE : ...................................... A.H. PHONE: ..............................................

Business Owner /Operator details
OWNER OR OPERATOR NAME(S): ...........................................................................................
(If the business is owned or operated by a company, then Insert Co. name here. Directors names go below.)
**(COMPANY/PARTNERSHIP/SOLE TRADER).
**ACN or REG. BUSINESS NUMBER: ...................

SUPPLIER REFERENCE (Name):........................................ (Phone):....................................
SUPPLIER REFERENCE (Name) :........................................ (Phone):....................................

I/We request payment terms for goods provided by the parties trading as Cakevan to the above business and (jointly and severally) accept personal liability for payment of debts properly incurred on this account until canceled in writing:-

NAME: .............................................................................D.O.B. ......./......./19..........
RESIDENTIAL ADDRESS: .....................................................................................................
SUBURB: ............................................ P/CODE: ........... A.H. PHONE: .....................
SIGNATURE: ...............................................................** (Director/Proprietor/Partner)

NAME: .............................................................................D.O.B. ......./......./19..........
RESIDENTIAL ADDRESS: .....................................................................................................
SUBURB: ............................................ P/CODE: ........... A.H. PHONE: .....................
SIGNATURE: ...............................................................** (Director/Proprietor/Partner)

NAME: .............................................................................D.O.B. ......./......./19..........
RESIDENTIAL ADDRESS: .....................................................................................................
SUBURB: ............................................ P/CODE: ........... A.H. PHONE: .....................
SIGNATURE: ...............................................................** (Director/Proprietor/Partner)

** (Delete as applicable)
ACCOUNTS ARE PROVIDED FOR CONVENIENCE OF DELIVERY ONLY, NOT AS A METHOD OF FINANCE.

PLEASE PAY ON INVOICES AS STATEMENTS ARE NOT NORMALLY ISSUED.
Terms will revert to "Strictly C.O.D." if payments are not remitted by due date.