Application for Credit
Waitomo District Landll
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
Section A - Applicant’s Details
Full Name of Company, Organisation or Partnership:
Trading Name:
Postal Address:
Street address or PO Box number:
Registered Ofce:
Work phone number: Mobile:
Email Address:
Bank:
Branch:
Section B - Directors
Section C - Trade References
Name of Company:
Name of Key Contact Person:
Address:
Phone Number: Email:
PLEASE COMPLETE USING UPPER CASE PRINT
Name: Position:
Private Address:
Telephone Number:
Mobile:
Email Address:
Estimated Amount of Credit Applied For: $
Please tick if you would like your
statements emailed to you
Name of Company:
Name of Key Contact Person:
Address:
Phone Number: Email:
Name: Position:
Private Address:
Telephone Number:
Mobile:
Email Address:
250485:003/004:RR11
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
Section D - Terms and Conditions
I/We certify that all particulars given in this application for a credit account are true and correct, and
request the Waitomo District Council to open an account for the Company, Organisation or Partnership
whose names appear on page one of this document.
We authorise the Waitomo District Council to make such credit inquiries as the Waitomo District Council
deems necessary. The following terms and conditions apply:
1. In these terms and conditions, “WDC” means the Waitomo District Council, “Customer” means the
person or organisation for whom this account is opened, Account” means account at WDC in the
name of the Customer.
2. Use for this account constitutes acceptance of the terms and conditions.
3. I/We hereby agree to pay the accounts by direct debit on the 20
th
of each month and that if the
direct debit dishonours we reserve the right to cancel the credit account or charge 2% interest.
4. I/We personally guarantee to pay the amount owed to the Waitomo District Council if the company
fails to make full payment.
5. Payment will be made by direct debit (form attached) and will be debited from the customers
account on the 20
th
of each month.
6. The total amount of credit outstanding shall become immediately due and payable to WDC:
(a) On the appointment of a liquidator or receiver of the Customer
(b) At the discretion of WDC if the Customer is in breach of these terms and conditions
7. WDC reserves the right to refuse disposal of waste on credit if the terms and conditions of this
agreement are not met.
8. The Customer may close the account provided we receive this request in writing and that the
accounts balance is fully paid to the Waitomo District Council.
9. WDC may amend the Terms and Conditions of this Contract by giving the Customer notice in
writing.
10. The Customer shall be liable for all costs of collection and legal fees incurred by WDC in recovering
any amounts not paid in accordance with these terms.
11. If the account remains unused for more than a year, Waitomo District Council reserves the right to
close the account. The customer will be notied of this closure by letter.
Accepted and Signed: Date:
Print Name: Position:
SIGNATURE OF DIRECTOR AS PERSONAL GUARANTOR:
Application for Credit
Waitomo District Landll
250485:003/004:RR11
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome