Credit Application Form

Queenstown Engineering (2009) Limited T/A

Queenstown Engineering

GST No: 102 239 423

120 Glenda Drive, Frankton, QUEENSTOWN 9300

Phone: (03) 442 3036

Email: info@queenstownengineering.co.nz

Web: www.queenstownengineering.co.nz

To Be Completed By Applicants - Please complete all sections and read the Terms of Trade. This is a Credit Account Application Form under the Construction Contracts Act 2002. Please read Part F of the Terms of Trade.

Your Details

Personal details

Please only complete this section if you are submitting as an individual.

Business details

Please only complete this section if you are submitting on behalf of a business.

Directors/Owners/Trustees

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Account Details

Trade References

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Declaration

I certify that the above information is true and correct and that I am authorised to make this application for credit. I have read and understood the Terms of Trade and agree to be bound by those terms. I authorise the use of my personal information as detailed in the Privacy Act clause therein.