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* Company	* ABN No.	* Trading Name
*Sole Trader / Partnership / Company / Name
Billing Address
Billing Address	City	Post Code
Country	State
Shipping Address
*Shipping Address	*City	*Post Code
*Country	*State
Contact Details
*Work Phone Number	Home Phone Number	Work Fax Number
* Mobile Phone	*Email Address	*Title
*First Name	*Last Name
*Image Verification

I/We hereby give Silky Colouration Pty Ltd (the “Company”) permission to seek Credit Information from the above named references and from any Credit Providers that may be named in a credit report issued by a Credit Reporting Agency. I/We understand that such information can include any information about my/our credit worthiness, credit standing, credit history or credit capacity that Credit Providers are allowed to give or receive from each other under the Privacy Act. Please note this is Application is strictly a 30 Day Trading Account from date of invoice. All late payments will incur a late payment fee of 1.25% per month. I/We being Director/s / Principal/s of the above applicant hereby certify that all information contained herein is correct and agree to the Terms and Conditions applicable to operating a credit account with the Company including, but not limited to, a fee of $20 if a payment is dishonoured, a 20% handling fee on any returns after 30 days and interest may be charged on overdue accounts. I/We also acknowledge and accept that I/We will be personally liable and guarantee (jointly and severally) the payment of all amounts due to the Company in respect of the operation of said account including any and all costs of recovery incurred by the Company Yes, I do Agree above Terms.

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