Credit Application | Allied Interest

Contact Information

Site Contact

Site Contact - Name & Position

Site Contact - Email

Site Contact - Phone Number

Purchase Order Contact

Purchase Order Contact - Name & Position

Purchase Order Contact - Email

Purchase Order Contact - Phone Number

Accounts Payable

Accounts Payable - Name & Position

Accounts Payable - Email

Accounts Payable - Phone Number

Business Details

Type of Business

Sole Trader

Partnership

Corporation

Other

If Other, please specify

Nature of Business

Year Established

Credit Information

Requested Credit Limit (AUD $)

Note: Allied Interest offers 14-day payment terms from invoice date for all approved accounts. This is fixed and not negotiable at the application stage.

Trade References

Trade Reference 1

Company Name

Contact Person

Phone Number

Email Address

Trade Reference 2

Company Name

Contact Person

Phone Number

Email Address

Site Inductions & Requirements

Does your business require a formal site induction process?

Yes

Induction Details (if applicable)

Induction Contact - Name & Position

Induction Contact - Email

Induction Contact - Phone

Does your site have specific safety protocols or PPE requirements?

Yes

Safety/PPE Details (if applicable)

Authorization

By submitting this application, you confirm that you have read, understood, and agree to Allied Interest Pty Ltd's Terms and Conditions, including 14-day payment terms and a 1.5% per month late payment fee. You authorize Allied Interest Pty Ltd to make inquiries into the banking and trade references supplied, and confirm you are duly authorized to sign this application on behalf of your company.

I have read, understood, and agree to Allied Interest Pty Ltd's Terms and Conditions.

Full Name of Authorised Signatory

Position/Title

Date Signed

Day

Month

Year

INDUSTRIAL AUTOMATION EXPERTS

Company Information