Credit Application FormPlease complete this online form as part of your Credit Application. Customer type * Accommodation Mining Healthcare Have you ever been an account customer with SPL before * Yes No Please select type of business * Company Partnership Sole Trader / Individual Other Registered business name * Trading name * ABN * Postal address * Email * Business address if different from Postal Phone (###) ### #### Accounts Payable Contact * First Name Last Name Email * Person responsible for purchasing * First Name Last Name Email * The credit sought by the customer * Business use Personal use (indicate available) INDIVIDUAL DETAILS Full particulars of sole trader, all partners & / Or directors 1. Name, Address, DOB & Drivers License No. 2. Name, Address, DOB & Drivers License No. 3. Name, Address, DOB & Drivers License No. 4. Name, Address, DOB & Drivers License No. BUSINESS PREMISES * Owned Leased Mortgaged Details of Lessor/Agent or Mortgage Name, Address, Phone TRADE REFERENCES Major suppliers where you are currently buying 1. Name, Suburb & Phone 2. Name, Suburb & Phone 3. Name, Suburb & Phone BANKER Bank name * Branch address * BSB * Account number * CREDIT LIMIT REQUESTED * Anticipated Monthly Credit Required $ Thank you! Your Account Creation details have been sent to our team for set up.