Phone: 1300 266 897
Email: sales@combinedtyres.com.au
Web: combinedtyres.com.au
ABN: 68 623 881 149
PERTH • NORTHAM • CUNDERDIN • KELLERBERRIN • MERREDIN • SOUTHERN CROSS • KALGOORLIE • LEONORA

Credit Account Application

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Business Information

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Please enter requested credit limit
Please enter trading name
Please enter legal business name
Please enter valid ABN (11 digits)
Please enter valid ACN (9 digits)

Contact Information

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Please enter billing address

Key Contacts

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Trade References

Please provide two current trade references (suppliers you have credit accounts with)

Trade Reference 1
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Trade Reference 2
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Terms and Conditions Agreement

I certify that the above information is true and that I am authorised to make this application for credit. I have read and understand the TERMS AND CONDITIONS OF TRADE of Combined Tyres PTY LTD which form part of, and are intended to be read in conjunction with this Credit Account Application and agree to be bound by these conditions.
I authorise the use of my personal information as detailed in the Privacy Act clause therein. I agree that if I am a director/shareholder (owning at least 15% of the shares) of the Client I shall be personally liable for the performance of the Client's obligations under this contract.
IMPORTANT: For every 30 days an account is overdue, an $11.00 account fee will be incurred and a 5% interest charge on the amount due. Interest on overdue invoices shall accrue daily at a rate of 2.5% per calendar month.
Authorized Representative - Electronic Signature
By completing the fields below and submitting this form, I am electronically signing this credit application. I acknowledge that my electronic signature has the same legal effect as a handwritten signature under the Electronic Transactions Act 1999 (Cth).
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