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Trade
Credit Account Application Form
"
*
" indicates required fields
1. Full legal name of applicant(s) (the “Purchaser”)
*
2. Trading name(s) (if different)
3. Legal status of the Purchaser
*
Select an option
Sole Trader
Partnership
Company
Trust
Other
Other
*
4. Postal address
*
5. Delivery address
6. Account Owner contact details
Mobile:
Email:
*
7. Accounts / Administration contact details (if not Account Owner)
Phone:
Email:
8. Orders / Logistics contact details (if not Account Owner)
Phone:
Email:
9. Type of business
Select an option
Electrical Contractor
Retailer / Wholesaler
Data / Telco Contractor
Industrial End User
Public entity (Govt / Local Authority related)
Private User (not contractor)
Industrial Integrator / OEM
Other
Other
Number of employees
Select an option
1 -5
6 - 49
50+
11. Establishment of the Purchaser
Year of establishment (registration, if company):
Company number (if relevant):
13. Trade reference of companies who extend credit facilities to you (excluding banks, telecom providers or power companies)
Name
Role
Home address
Name
Role
Home address
Name
Role
Home address
Name
Role
Home address
Name
Role
Home address
12. Details of all current owners, directors, partners, and/or trustees
Name
Contact
Phone
Email
Name
Contact
Phone
Email
Name
Contact
Phone
Email
Signature
Δ
Current Generation Ltd
129 Pascoe Street, Annesbrook, Nelson 7011
0800 202 700
03 547 8369
info@currentgeneration.co.nz
The power is in your hands