Documente Academic
Documente Profesional
Documente Cultură
Queensland Bulk Terminals Pty. Ltd. 156 Colmslie Road, Murarrie QLD 4172 PO Box 106, Sumner Park, QLD 4074 Australia Tel: +61 7 3902 0350 Fax: +61 7 3399 8460 ABN 89 138 437 260
CREDIT APPLICATION
Full Legal Trading Name: ABN / ACN: Physical address of Business:
Email: Anne.LeProu@wilmargavilon.com
Fax: (
Private Company
Partnership
Public Company
Sole Trader
NAME
POSITION
MOBILE No.
Business References 1. Company Name: Contact: 2. Company Name: Contact: 3. Company Name: Contact: 4. Company Name: Contact: Phone: ( ) Fax: ( ) Phone: ( ) Fax: ( ) Phone: ( ) Fax: ( ) Phone: ( ) Fax: ( )
Date:
Signature:
Full Name of Signatory: Address of Signatory: Full Name of Witness: Address of Witness: Date: / / Signature: Witness Signature:
Full Name of Signatory: Address of Signatory: Full Name of Witness: Address of Witness: Date: / / Signature: Witness Signature:
Full Name of Signatory: Address of Signatory: Full Name of Witness: Address of Witness: Witness Signature: