Customer Credit Account Application Form
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1FOR OFFICE USE ONLY
Account Number:
NZ New Customer Credit Account Application Form
nzcats@staplesnz.co.nz
Please forward for processing to:
Email:
CUSTOMER’S DETAILS
Trading Name / Applicant
Legal Entity
Industry
No. of Staff
(if different from trading name)
NZCN / DOB (if Sole Trader / Partnership) (Partnership – Please also provide Deed of Partnership)
NZBN
Proprietor’s Name/s if a sole Trader or Partnership
Date of Birth required for Credit check
Registered Office Address
Suburb
Postcode
Postal Address
Suburb
Postcode
Accounts Landline Tel. No.
Accounts Fax No.
Accounts Email
Receive Statements
Delivery Address (no PO Box)
Suburb
Postcode
Tel. No.
Fax No.
Email
Details of Relevant Contacts:
First Name
Last Name
Job Title
Email Address
CUSTOMER’S TRADE REFERENCES
1. Commercial Supplier: Contact
Telephone
Address
2. Commercial Supplier: Contact
Telephone
Address
CUSTOMER’S SIGNATURE
By signing this Application, the Customer hereby accepts Staples’ Terms and Conditions of Credit and Terms and
FOR OFFICE USE ONLY
Conditions of Sale. A copy of which is located at
Terms & Conditions
Signed for and on behalf of the applicant:
Sales Representative:
Signature
Date
Rep Code:
Department:
Name (Please use BLOCK CAPITALS)
Position
Credit Admin Approval:
Credit Limit:
Date:
Staples New Zealand Limited NZBN 94 2903198074 6
Duns No:
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Parent category: Business