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Business Name,
Delivery & Mail Address:
TRADING NAME:..........................................................................................................................
DELIVERY ADDRESS:
.................................................................................................................
SUBURB:
....................................................................................................................................
PHONE: ............................................... FAX:
..........................................................
SPECIAL DELIVERY INSTRUCTIONS (If
Applicable).........................................................
NEAREST CROSS
STREET:..................................OPENING TIMES:
............................................
MAIL
ADDRESS:..........................................................................................................................
SUBURB:..................................................................................................................................
PHONE: ........................................... FAX:
....................................
Main Contact Person
REPRESENTATIVE NAME:
...........................................(Proprietor/Director/Manager/Cake
orders)**
BUSINESS PHONE : ...................................... A.H.
PHONE: ..............................................
Business
Owner /Operator details
OWNER OR OPERATOR NAME(S):
...........................................................................................
(If the business
is owned or operated by a company, then Insert Co. name here. Directors names go below.)
**(COMPANY/PARTNERSHIP/SOLE TRADER). **ACN or REG. BUSINESS NUMBER: ...................
SUPPLIER REFERENCE (Name):........................................
(Phone):....................................
SUPPLIER REFERENCE (Name)
:........................................
(Phone):....................................
I/We request payment terms for
goods provided by the parties trading as Epicurean Kitchen to the
above business and (jointly and severally) accept personal
liability for payment of debts properly incurred on this account
until canceled in writing:-
NAME:
.............................................................................D.O.B.
......./......./19..........
RESIDENTIAL ADDRESS:
.....................................................................................................
SUBURB: ............................................ P/CODE:
........... A.H. PHONE: .....................
SIGNATURE:
...............................................................**
(Director/Proprietor/Partner)
NAME:
.............................................................................D.O.B.
......./......./19..........
RESIDENTIAL ADDRESS:
.....................................................................................................
SUBURB: ............................................ P/CODE:
........... A.H. PHONE: .....................
SIGNATURE:
...............................................................**
(Director/Proprietor/Partner)
NAME:
.............................................................................D.O.B.
......./......./19..........
RESIDENTIAL ADDRESS:
.....................................................................................................
SUBURB: ............................................ P/CODE:
........... A.H. PHONE: .....................
SIGNATURE:
...............................................................**
(Director/Proprietor/Partner)
** (Delete as
applicable)
ACCOUNTS ARE PROVIDED FOR CONVENIENCE OF DELIVERY ONLY, NOT
AS A METHOD OF FINANCE.
PLEASE PAY ON INVOICES AS STATEMENTS ARE NOT NORMALLY ISSUED.
Terms will
revert to "Strictly C.O.D." if payments are not
remitted by due date.
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