SKAH International Pty Ltd T/A Stealth Garden Supplies
PO Box 216, SEACLIFF PARK SA 5049
Telephone: 1800 072 151

ACCOUNT APPLICATION FORM

Business Name:

Company Name:

Year Established:

ACN:

ABN:

Street Address:

Suburb

State:

Postcode:

Phone Number:

Mobile Number:

Fax Number:

Forklift?

Special Delivery Instructions:

Name of Director / Partner #1

Position Held:

Home Address:

Home Phone:

Name of Director / Partner #2

Position Held:

Home Address:

Home Phone:

Accounts Payable Contact:

Direct Phone Number:

Email Address:

Company Name (Reference 1):

Address:

Contact:

Phone Number:

Approx $ per Month

Company Name (Reference 2):

Address:

Contact:

Phone Number:

Approx $ per Month

Company Name (Reference 3):

Address:

Contact:

Phone Number:

Approx $ per Month

Name In Full:

Position:

Date:

Sign:

I acknowledge that the information provided is accurate to the best of my knowledge. Any direct misleading of information will result in instant termination of account / account submission.

ACCOUNT APPLICATION FORM

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