Request For Credit Application

Your Company Details
Company: Telephone:
Address: Fax:
Type Of Business: First Trading Date:
Nature Of Business: Date Company Formed:
ABN Number:

Please List at Least Two Company Officers (or Principal Partners in Case of partnership)
Name Title Address
Your Bank Details
Bank Name & Address:
Account No. BSB: Contact:
Trade References. Please supply the names of two unconnected companies who we may contact for a trade reference.
Company Name Address Contact/Tel
Amount Of Credit Requested:  AUD
In consideration of Kangaroo International express (Hereinafter referred to as 'The Company') granting credit to the customer, the customer affirms & agrees to The Company's terms and conditions, a copy of which are available upon request.