We have had a large number of requests to supply our clients or prospective debt collection clients with a credit application form. Such a form needs to be tailored individually for each client however the fields below may assist you in the design of yours. This information is a sample only and is not intended for resale or copying. We can have our solicitors draw up a document for you; a fee will apply.
- CREDIT APPLICATION FORM Your Company Name Pty Ltd (THE SUPPLIER)
- APPLICANTS COMPANY OR PERSONAL NAME/s (THE CLIENT)
- TRADING NAME (If different to above)
- AUSTRALIAN BUSINESS NUMBER (ABN)
- TRADING ADDRESS
- POSTAL ADDRESS
- BUSINESS PHONE NUMBER
- BUSINESS FAX NUMBER
- BUSINESS EMAIL ADDRESS
- BUSINESS WEB SITE ADDRESS
- DIRECTORS / PROPRIETORS NAME/S
- DIRECTORS / PROPRIETORS PERSONAL ADDRESS
- DIRECTORS / PROPRIETORS MOBILE PHONE NUMBER
- DIRECTORS / PROPRIETORS HOME PHONE NUMBER
- DIRECTORS / PROPRIETORS EMAIL ADDRESS
- NATURE OF YOUR BUSINESS
- CREDIT LIMIT REQUESTED $
- TRADE REFERENCES (at least 3)
(The following is a sample only of clauses that should be considered)
The client should consider the following clauses that shall govern all dealings between them and the supplier.
(Whatever you want to include relevant to your business dealings)
All goods supplied shall remain the property of the supplier until such time as they are paid for. The client shall allow the supplier access to their property for the purpose of reclaiming such goods.
Payment terms are strictly 30 days
The supplier may charge a monthly administration fee equal to an interest rate calculated under the Penalty Interest Rates Act 1983 or $25.00 (whichever is the greater) on all accounts exceeding our payment terms
Any person signing this agreement acknowledges that they are a proprietor or director of the client. In signing this agreement they agree unconditionally to be jointly and severally liable for any debts owed to the supplier by the client.
- NAME OF PERSON SIGNING THIS APPLICATION
(In signing this agreement I undertake that I have read and understand its content. I agree personally and on behalf of the client to be bound by all aspects of the agreement. I further confirm that I have had the opportunity to seek legal advise)
Jurisdiction for any proceedings shall always be in the state of (Your Home state)
In the event of any payment default by the client, the supplier shall be able to request full payment of the entire debt outstanding to it and not just the overdue component.
In the event of a payment default the client shall be responsible for all costs associated with the collection of the debt by the supplier. This shall include all costs of a debt collection agency including any forecast commissions payable.
The client authorises the supplier to undertake any credit checks that it deems necessary in evaluating this credit application or at any later time as is deemed necessary. This shall include discussion with other interested credit providers to the client.