Trade Account Application BUSINESS STRUCTURE AND DETAILSTrading Name* Structure*Sole TraderPartnershipProprietary LimitedPublic ListedTrustGovernmentABN ACN Registered Address* Street Address City State / Province / Region ZIP / Postal Code Trading Commenced* DD slash MM slash YYYY Business Phone #* Business Email* PART A: PROPRIETOR(S)/TRUSTEE DETAILS ONLY COMPLETE THIS SECTION FOR SOLE TRADERS, PARTNERSHIPS AND INDIVIDUAL TRUSTEESFirst Name Partner Last Name Account RoleProprietorPartnerTrusteeDate of Birth DD slash MM slash YYYY Drivers License # License IssuerACTNSWNTQLDSATASVICWAResidential Address Street Address City State / Province / Region ZIP / Postal Code Partner First Name Partner Last Name Account RoleProprietorPartnerTrusteePartner Date of Birth DD slash MM slash YYYY Partner Drivers License # Partner License IssuerACTNSWNTQLDSATASVICWAPartner Residential Address Street Address City State / Province / Region ZIP / Postal Code PART B: COMPANY DETAILS ONLY COMPLETE THIS SECTION FOR COMPANIES AND TRUSTS THAT HAVE A COMPANY TRUSTEE PLEASE NOTE ANY MIDDLE NAMES ARE REQUIREDRegistered Company Name List of DirectorsPART C: TRUST AND BENEFICIARY DETAILS ONLY COMPLETE THIS SECTION FOR TRUSTSRegistered Name of Trust Type of Trust List of BeneficiariesACCOUNT CONTACT FOR BILLING ENQUIRIESContact First Name Contact Last Name Contact Role*Use Details from Part AAccounts PayableBookkeeperContact Email* Contact Phone* BANK DETAILS USED FOR PROCESSING REFUNDSBank Account Name Bank BSB NumberBank Account NumberTRADE REFERENCESTrade Reference 1* Reference 1 Phone #* Reference 1 Email Reference 1 Trading Since* MM slash DD slash YYYY Trade Reference 2* Reference 2 Phone #* Reference 2 Email Reference 2 Trading Since* MM slash DD slash YYYY Trade Reference 3* Reference 3 Phone #* Reference 3 Email Reference 3 Trading Since* MM slash DD slash YYYY TERMS & CONDITIONS OF TRADEConsent* I have read & agree to the Terms & Conditions of Trade.Terms & Conditions of TradeCAPTCHA