Title:
Company name *:
NZBN *:
Phone *:
Fax:
E-mail *:
Registered company address *:
City *:
Region:
Postal Code:
Date business commenced *:
Organisation type: —Please choose an option—Sole proprietorshipPartnershipLimited Liability CompanyOther
If other, please provide your organisation type:
Primary business address *:
How long at current address? *:
Bank name:
Bank address:
Phone:
City:
Type of account: —Please choose an option—SavingsChequeOther
Account number:
Address *:
Type of account:
All Final invoices are to be paid by 20th Month following & Disbursement Invoices to be paid 7 days from invoice date.
Claims arising from invoices must be made within seven working days.
By submitting this application, you authorize Jacanna Customs & Freight to make inquiries into the banking and business/trade references that you have supplied.
Please tick this box to confirm that you have read and accept Jacanna Customs & Freight's Terms and Conditions in conjunction with the above points.
Title *:
Name *:
Date *:
Name:
Date:
Δ