NEW CUSTOMER CREDIT APPLICATION FORM

PLEASE COMPLETE THIS FORM AND EMAIL TO prodline@gmail.com

Section 1 – Applicant’s details (Enter all details relevant to your business)

Registered Business Name:

Trading as (if different):

SELECT:
Company Sole Proprietor ⃝ Partnership ⃝ Corporation ⃝ Government/Statutory Authority ⃝

Nature of Business:

Date of Company Registration: How long have you owned the business?

Registered Office Address (house number, building, street name, barangay): City: Province: Postcode:

Delivery Address (if different) (house number, building, street name,

City: Province: Postcode:
barangay):

Contact Person: Address for invoices:

Office Telephone Number: Fax Number for invoices:

Mobile Number: Email Address for invoices:

Partner, Sole Trader, Director or Trustee details

Name of Directors (if company),
Residential Address Contact Number Email Date of Birth
Partners or Sole Trader

Trade References
Company Name Contact Name Contact Number Email

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CREDIT APPLICATION FORM (CONTINUED)
Bank References
Bank Address Account Name
Section 2 – Credit Account Terms and Conditions
1) Application of Credit Terms and Supply Terms
a) By submitting this Credit Application Form to the Productline business(es),
the person described in Section 1 (Applicant) applies for the supply of
goods or services by the Supplier on credit terms (Application), and agrees
to be bound by:
i) the Credit Account Terms and Conditions contained in this Section 3
(Credit Terms); and
ii) the Terms and Conditions attached to this Credit Application Form, as
may be amended or replaced by the Supplier from time to time (Supply
Terms).
b) To the extent of any inconsistency between the Credit Terms and the
Supply Terms, the Credit Terms prevail. .
2) Credit Approval
a) The Supplier has absolute discretion to approve or refuse the Application,
and will notify the Applicant of its decision within 30 days of the submission
of the Application.
b) If the Supplier approves the Application, it will establish a credit account in
respect of the Applicant (Credit Account) and the Applicant will be a "Credit
Customer" for the purposes of these Credit Terms and the Supply Terms.
749839535.docx
Account Number Contact Name Contact Number
3) Suspension and Cancellation of Credit Account
a) The Applicant may at any time terminate its Credit Account by notice in
writing to the Supplier provided that all debts, liabilities and obligations
owed to the Supplier have been satisfied.
b) The Supplier may at any time suspend or terminate the Credit Account of an
Applicant by:
i) giving immediate notice to the Applicant upon any default by the
Applicant under the Credit Terms or Supply Terms, or if the Credit
Account has previously been suspended for more than 30 days; or
ii) giving at least 30 days’ notice to the Applicant.
c) The Supplier has absolute discretion in determining the length of any
suspension of a Credit Account under clause 3(b).
d) For the avoidance of doubt, any suspension or termination of an Applicant’s
Credit Account under this clause 3 does not release the Applicant from any
of its obligations (including any obligation to make payment to the Supplier)
under the Credit Terms and the Supply Terms.
4) Privacy
The Applicant and each Guarantor acknowledges and agrees that:
a) Some or all of the information concerning the Applicant and
Guarantor referred to in this clause 4 may be Personal Information.
b) The Supplier may obtain from time to time reports as to the
Applicant’s and the Guarantor's creditworthiness from any credit
reporting agency.
c) The Supplier may contact trade referees, financial institutions, other
providers of credit to the Applicant and other persons at any time for
the purpose of ascertaining or monitoring the Applicant’s
creditworthiness.
d) The Supplier may receive information concerning the Customer and
Guarantor from any of the persons described in clauses 4(b), and 4(c)
herein, and disclose information concerning the Applicant and
Guarantor to any of those persons for the purpose of ascertaining or
monitoring the Applicant’s and the Guarantor's creditworthiness.
e) If the Applicant or a Guarantor defaults in their payment obligations
to the Supplier, the Supplier may disclose all or any information
relating to the Applicant’s account to a collection agency for the
purpose of recovering outstanding moneys.
Credit Application Form Page 2 of 3
CREDIT APPLICATION FORM (CONTINUED)
Section 3 – Acknowledgement
The Applicant agrees to be bound by the Credit Terms in section 2 of this Credit Application Form and the attached Terms and
Conditions.

Who must sign this Credit Application Form on behalf of the Applicant:
For Companies: Where there is only one director for the company then that person must sign; where there are two or more directors for the
company then 2 Directors, or a Director and Company Secretary must sign.
For Sole Traders operating under their own name or under a business name: The individual must sign.
Partnerships: All Partners of the Partnership must sign.

Signatory Witness
Print Name Print Name

Position Position

Signature Signature

Date / / Date / /

Signatory Witness

Print Name Print Name

Position Position

Signature Signature

Date / / Date / /

Signatory Witness

Print Name Print Name

Position Position

Signature Signature

Date / / Date / /

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