Application for Company Credit Account

Please print and complete this form. Fax or mail to the following address:

                                                                                   COMSERV (No. 3070) Pty Limited Incorporated in N.S.W. Trading as
Sydney Weighbridges Pty Limited.                                                                       Standard Auto Weigh
ABN 34 135 925 656                                                                                                                                                       ABN 53 003 909 420
14 Sammut Street                                                                                                  Telephone: (02) 9604 2677
Smithfield   NSW   2164                                                                                          Facsimile: (02) 9604 2599
Email: roger@weighbridges.com.au                                                           Website: www.weighbridges.com.au

APPLICATION FOR 30 DAY CREDIT ACCOUNT

COMPLETE IF A REGISTERED PUBLIC COMPANY OR PTY LTD:

Company:   
Street Address:   
State:                            Postcode:   
Email:   
Postal Address:   
State:                            Postcode:   
ABN No:           ACN No:   
Phone:           Fax:           Mobile:   

COMPLETE IF AN INDIVIDUAL/PARTNERSHIP/REGISTERED BUSINESS NAME:

Surname:           Given Names:   
Street Address:
State:                            Postcode:   
Email:   
Postal Address:
State:                            Postcode:   
Phone:           Fax:           Mobile:   
Driver's Licence No:           State Where Held:   
Date Of Birth:                         Marital Status:   
Spouse's Name:                  Occupation:   

SMART CARD REQUEST
For after hours weighing (not for Trade Measurement)

Please supply   Smart Card(s) at $30 EACH (GST INCLUDED).

ALL APPLICANTS COMPLETE:

I/We agree to abide by the above Credit term and to advise SYDNEY WEIGHBRIDGES PTY LTD of any change to the above details.
I/We give permission for Sydney Weighbridges Pty Ltd to check my/our commercial and consumer credit files with Veda Check.
I/We understand that the account payment must be received within 30 days of Tax Invoice or a financial charge of 20% per month will be applicable to the account payment date.
If accounts are not paid within 60 days of Tax Invoice date, collection agency costs will be added to my/our account.

Signature of authorised person/applicant:

Date:

Position:

Name (Please Print):









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