
APPLICATION FOR CREDIT FACILITIES
As the applicant, we hereby apply for an account credit facility for the opening of an account with Onlineindustrial Pty Ltd.
Registration No. 2017/06446/07 Domicile: 23, N12 Industrial Park, 188 Dr Vosloo Road, Bartlett, Boksburg, Gauteng 1459.
ACCOUNT TERMS AND CONDITIONS
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Preamble
- I the applicant hereby warrant that I am duly authorized by the debtor, āweā, āthe undersignedā, āclientā to apply for the account credit facility on its behalf and that all details and information within is true and correct.
- I, we hereby confirm that I, we have read and understood Onlineindustrial account terms and conditions, Onlineindustrial General terms and conditions and furthermore accept and acknowledge that these terms and conditions form part of this application.
- I, we hereby accept and acknowledge that under the provisioning of Onlineindustrial terms and conditions, product/s in association and supplied by Onlineindustrial are bound to OEM/manufacture/importer terms and conditions.
- Account credit facilities may only be considered once the original application form and requested documentation is completed and signed by an authorized owner, partner, director, or member and received by Onlineindustrial accounts administration.
- I, we hereby warrant and agree to notify Onlineindustrial immediately of any changes to information and details, ownership hereof, within the account credit application. (For your own safety and ours please notify us immediately of any procurement staffās dismissal.)
- I, we agree to abide by the limits and terms designated by Onlineindustrial.
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Terms and condition of sale
- No orders placed with Onlineindustrial will be binding until accepted by Onlineindustrial Pty Ltd.
- Onlineindustrial reserves the right to not accept, cancel orders placed.
- Onlineindustrial shall not be deemed liable nor responsible for order/s not processed without an official order.
- I, we agree any form of order/s is legally binding to the clientās liability and accountability, such as but not limited to verbal orders, email orders or any other form of communication and instruction.
- Onlineindustrial may decline an order if the order quantity does not comply with minimum quantity order/s. Onlineindustrial will duly notify the client thereof.
- All product/s availability and price/s are quoted at time of inquiry and may differ at time of purchase/s, of which Onlineindustrial shall not be deemed liable for any stock shortages, price variations, delays, loss, damage or whatsoever thereof. All price/s quoted exclude VAT and transportation fees.
- All prices are quoted in (ZAR) South African Rand.
- The applicantās delivery address may not be changed without prior notification accepted by Onlineindustrial of which Onlineindustrial may charge additional delivery fees if applicable and shall not be held responsible liable for delays, loss, expenses or whatsoever thereof. In the event of order cancellation by the client in such an event, the client agrees to be liable for any charges, expenses incurred from the transaction and return/cancellation of order/s.
- Any changes in the ordered quantities will be charged on a pro-rata basis according to relevant applicable prices as in offer, if agreed in writing, and subject to the condition that Onlineindustrial has sufficient stock on hand.
- The invoice price reflected on Onlineindustrial invoice shall be paid by the account holder without any deduction, and in accordance with the terms of payment which the parties hereto might from time to time agree.
- Onlineindustrial reserves the right to invoice portions/part order/s, as and when delivered to the applicant.
- The account holder may not transfer, assign, cede any of its rights or delegate any of its obligations arising out of this agreement.
- The account holder may not return any products or services to Onlineindustrial in lieu of payment of any debt due by the account holder to Onlineindustrial.
- Onlineindustrial reserves the right to revoke the account holderās order/s, and request that the customer pay in advance for products purchased/ordered.
- Onlineindustrial products purchased/used/operated by the applicant, user, third party shall be deemed liable, capable, trained, and experienced in the use and maintenance of the product/s and the applicant indemnifies Onlineindustrial for any damages, loss, expenses or whatsoever thereof.
- The applicant agrees and permits Onlineindustrial to share any information in this application with any Credit bureau, trade credit insurer, risk management agent, debt collector, who in turn may share this information with 3rd parties for the purpose of credit risk assessment, credit risk analysis, debt collection, payment performance, payment default and specifically regarding the applicant meeting their obligations under any trade credit facility granted under this application.
- Onlineindustrial 30 Days Account holders are stickly thirty days from date of invoice/ first monthās statement, and may not carry invoices, payment/s, nor withheld any payment/s for whatsoever reason into 60 Days from date of invoice/first statement. In the event of such infringement the client will be liable for a 20% interest per 30 days, as per outstanding statement value and thus agrees to full liability and responsibility of any additional fees and charges, collection fees, legal fees, tracing agents pertained to and from Onlineindustrial Pty Ltd and associates, that may be incurred thereof. The customer further agrees that in the event of its default in any respect whatsoever towards the creditor, the creditor shall be entitled to place the customer on āStop supplyā without any notice notwithstanding that the customer may have placed on order for the supply of goods prior to the stop supply date. The customer, account holder, directors, surety/ies hereby consent to the jurisdiction of the Magistrateās court for all actions, which may be instituted against one, or all for the recovery of any amounts owing to the creditor and associates. All goods and services remain the property of Onlineindustrial Pty Ltd until full payment has been received by the creditor in respect of any such goods supplied to the customer and interests, fees, penalties paid in full. No amendment and/or alteration and/or variation and/or deletion and/or addition and/or cancellation of these terms and conditions, whether consensual and unilateral and bilateral shall be of any force and effect unless reduced to writing and signed by the creditor. No agreement, whether consensual or unilateral or bilateral, purporting to obligate the creditor to sign and written agreement to amend, alter, vary, delete, add, or cancel these terms and conditions shall be of any force and effect unless reduced to writing and signed by the creditor.Ā No warranties, representations or guarantee have been made by the creditor or on its behalf which may have induced the customer and/or the surety to sign this document.
- Buyouts and special purchases are strictly COD, other than agreed upon by Onlineindustrial Pty Ltd.
- Onlineindustrial 30 Days COD current account holdersā payments are due on the 1st of each month and may not carry invoices, payment/s, nor withheld any payment/s for whatsoever reason into 30 Days. In the event of such infringement the client will be liable for a 20% interest per 30 days, as per outstanding statement value and thus agrees to full liability and responsibility of any additional fees and charges, collection fees, legal fees, tracing agents pertained to and from Onlineindustrial Pty Ltd and associates, that may be incurred thereof. The customer further agrees that in the event of its default in any respect whatsoever towards the creditor, the creditor shall be entitled to place the customer on āStop supplyā without any notice notwithstanding that the customer may have placed on order for the supply of goods prior to the stop supply date. The customer, account holder, directors, surety/ies hereby consent to the jurisdiction of the Magistrateās court for all actions, which may be instituted against one, or all for the recovery of any amounts owing to the creditor and associates. All goods and services remain the property of Onlineindustrial Pty Ltd until full payment has been received by the creditor in respect of any such goods supplied to the customer and interests, fees, penalties paid in full. No amendment and/or alteration and/or variation and/or deletion and/or addition and/or cancellation of these terms and conditions, whether consensual and unilateral and bilateral shall be of any force and effect unless reduced to writing and signed by the creditor. No agreement, whether consensual or unilateral or bilateral, purporting to obligate the creditor to sign and written agreement to amend, alter, vary, delete, add, or cancel these terms and conditions shall be of any force and effect unless reduced to writing and signed by the creditor.Ā No warranties, representations or guarantee have been made by the creditor or on its behalf which may have induced the customer and/or the surety to sign this document.
- For all purposes under this agreement including giving of any notice, the services of any process and for all other purposes arising from this agreement, the customer and the surety/ies hereby choose domicilium citandi et executandi at the physical address of the customer stipulated and of the face hereof.
- No relaxation or indulgence granted by the creditor to the customer and/or the surety/ies shall be deemed to be a waiver of any of the rights of this agreement and the customer agrees to operation of law (Confusio or commixtio) from goods received incorrect, generic nature, broken, used.
- The signatory/customer/user hereby binds himself/herself in his/her personal capacity as director (in the case of a company), member (in the case of a close corporation) or owner or partner as co-debtor jointly and severally for the full amount due to Onlineindustrial and agrees that these terms and conditions will apply mutatis mutandis to him/her.
- I, we the undersigned hereby agree and permit Onlineindustrial entitlement to:
2.2.1 Access information and data of any credit bureau or its agents or its clients pertaining to āCompanyā.
2.2.2 Access information and data of any credit bureau or its agents or its clients pertaining to āDirectors, members, partnersā.
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Signed at ___________________________Ā Ā on this dateĀ Ā Ā YYYY/MM/DD Ā Ā by (Print name): ________________________________
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Signature (Applicant) _________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Director (Member): _____________________________Ā Ā
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As witness Name: ___________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Witness signature: _____________________________
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APPLICATION FOR CREDIT FACILITIES
APPLICANT PROFILE
Type of business entity:Ā Ā Ā Ā Ā Ā
Public company |
Private company |
Closed corporation |
Sole Proprietor |
Joint Venture |
Trust |
Consortium |
Government |
Partnership |
Ā Ā Ā Ā Other (Specify) |
Business nature:Ā Ā Ā Ā Ā Ā
Agent |
Distributor |
Consultant |
Contractor |
Ecommerce |
End user |
Free Lancer |
Manufacture |
Merchant |
Retailer |
Wholesaler |
Importer |
Exporter |
Service Provider |
Ā Ā Ā Ā Ā Ā Other (Specify) |
Type of business industry:Ā Ā Ā Ā Ā Ā
Advertisement |
Aerospace |
Agriculture |
Architecture |
Arts |
Automation |
Automotive |
Carpentry |
Catering |
Chemical |
Computer |
Construction |
Civil |
Earth Moving |
Education |
Electrical |
Electronics |
Energy |
Entertainment |
Engineering |
Farming |
Fashion |
Finance |
Fishing |
Food |
Forestry |
Government |
Health Care |
Hospitality |
I.T |
Manufacturing |
Media |
Mining |
Music |
Petroleum |
Pharmaceutical |
Plumbing |
Real estate |
Recycling |
Software |
Technology |
Telecommunication |
Textile |
Tourism |
Trade |
Transportation |
Turnkey |
Water Works |
Ā Ā Ā Ā Other (Specify) |
South African Provinces of business conduct:Ā Ā Ā Ā Ā Ā
Eastern Cape |
Free State |
Gauteng |
KwaZulu Natal |
Limpopo |
Mpumalanga |
Northern Cape |
Northwest |
Western Cape |
Ā Ā Ā Ā Ā Other (Specify) |
Countries of business conduct:Ā Ā Ā Ā Ā Ā
Algeria |
Angola |
Benin |
Botswana |
Burkina Faso |
Burundi |
Cabo Verde |
Cameroon |
CAR |
Chad |
Comoros |
Congo (DRC) |
Djibouti |
Egypt |
Equatorial Guinea |
Eritrea |
Eswatini |
Ethiopia |
Gabon |
Gambia |
Ghana |
Guinea |
Guinea-Bissau |
Kenya |
Lesotho |
Liberia |
Libya |
Madagascar |
Malawi |
Mali |
Mauritania |
Mauritius |
Morocco |
Mozambique |
Namibia |
Niger |
Nigeria |
Rwanda |
Sao Tome & Principe |
Senegal |
Seychelles |
Sierra Leone |
Somalia |
South Africa |
South Sudan |
Sudan |
Tanzania |
Togo |
Tunisia |
Uganda |
Zambia |
Zimbabwe |
Ā Ā Ā Ā Ā Other (Specify) |
Product categories of interest:Ā Ā Ā Ā Ā Ā
Abrasives |
Adhesives & Tapes |
Bearings |
Branding |
Brush ware |
Construction equipment |
Chemicals |
Cutting tools |
Electric motors |
Electrical equipment & instrumentation |
Electrical control panels |
Fasteners & flanges |
Landscaping equipment |
Generators & machinery |
Hardware |
Hydraulic fittings & hoses |
Irrigation equipment |
Janitorial equipment |
Lifting equipment |
Lighting equipment |
Lubricants |
Machine tools |
Machinery |
Measuring tools & instrumentation |
Medical equipment |
Milling & Turning consumables |
Mobility equipment |
Packaging equipment |
Paints |
Plastic ware |
Polyurethane wear parts |
Pneumatic tools |
Pumps |
PTFE products |
Site maintenance equipment |
Solar products |
Stationary |
Ropes |
Tools |
Valves |
Welding Alloys & consumables |
Welding machines |
Workshop equipment |
Ā Ā Ā Ā Ā Ā Ā Ā Ā Other (Specify) |
APPLICATION FOR CREDIT FACILITIES
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COMPANY DETAILS
0-1 |
2-4 |
5-10 |
10-20 |
Number of Company branches:Ā Ā Ā Ā Ā Ā
Number of employees:Ā Ā Ā Ā Ā Ā
0-4 |
5-10 |
10-20 |
20-50 |
50-100 |
100+ |
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Date of application:Ā Ā Ā Ā YYYY/MM/DDĀ Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Date established:Ā Ā Ā Ā YYYY/MM/DD
Registration No.Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā /Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā /Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā VAT. No.Ā Ā ________________________-
Company trading name: Ā Ā ___________________________________Ā Ā Company registered name:Ā ___________________________________
Domicilium citandi et executandi / Company address:Ā _______________________________________________________________________
Town: __________________Ā Ā State/Province: _______________________Ā Ā Ā Country: _______________________Ā Ā Postal Code: ___________
Company postal address: _______________________________________________________________________________________________
Delivery address:Ā _____________________________________________________________________________________________________
Town: __________________Ā Ā State/Province: _______________________Ā Ā Ā Country: _______________________Ā Ā Postal Code: ___________
Hand |
Post |
Subject to National credit act, the customer elects to receive notices at its domicilium address above by
CONTACT DETAILS
Company Tel No. _________________Ā Ā Ā Fax No. __________________Ā Ā Ā Cell No. __________________Ā Ā Email: _________________________
Accountant Name:Ā _________________________________________Ā Ā Ā Ā Tel No. __________________Ā Ā Ā Email: _________________________
Procurement manager Name:Ā ________________________________ Ā Ā Ā Ā Tel No. __________________Ā Ā Ā Email: _________________________
Buyer Name:Ā ______________________________________________Ā Ā Ā Ā Tel No. __________________Ā Ā Ā Email: _________________________
Buyer Name:Ā ______________________________________________Ā Ā Ā Ā Tel No. __________________Ā Ā Ā Email: _________________________
Factory foreman/manager Name:Ā ______________________________Ā Ā Ā Tel No. __________________Ā Ā Ā Email: _________________________
Inventory/Stock controller Name:Ā ______________________________Ā Ā Ā Tel No. __________________Ā Ā Ā Email: _________________________
DIRECTOR/S DETAILS
(Names of directors of the company, members, partners, trustees)
Full Name: _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Full Name: _____________________________________Ā
I.D No.Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā I.D No.Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Address:Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Address:Ā Ā Ā Ā _____________________________________
Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Tel No.Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Tel No.Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā
Shares:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā %Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Shares:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā % Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Full Name: _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Full Name: _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
I.D No.Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā I.D No.Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Address:Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Address:Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Tel No.Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Tel No.Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā
Shares:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā % Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Shares:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā % Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
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APPLICATION FOR CREDIT FACILITIES
TRADE REFERENCES
Company:Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Company:Ā Ā Ā _____________________________________Ā
Contact:Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Contact:Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Tel No. Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Tel No.Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Email:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Email:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Credit limit: _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Credit limit: _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Company:Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Company:Ā Ā Ā _____________________________________Ā
Contact:Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Contact:Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Tel No.Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Tel No.Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Email:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Email:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________________
Credit limit: _____________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Credit limit: _____________________________________Ā Ā Ā Ā Ā
Rented |
Owned |
0-1 |
2-4 |
5-10 |
10-20 |
Property ownership:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Rental age:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Property landlord Name:Ā ______________________________Ā Ā Ā Tel No. __________________Ā Ā Ā Email: _________________________Ā Ā Ā Ā
BANKING DETAILS
Year opened:Ā Ā Ā Ā YYYY/MM/DDĀ Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā
Bank Name:Ā Ā Ā Ā __________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Account holder Name: _____________________________
Branch Name:Ā __________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Branch Code:Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________
Account Type:Ā __________________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Account Number:Ā Ā Ā Ā Ā Ā Ā Ā Ā _____________________________
TRADE CREDIT FACILITY
30 Day Current Account |
30 Day Account |
Type of Account:
Credit limit Request:Ā Ā Ā Ā Ā Ā
R10Ā 000.00 |
R20Ā 000.00 |
R30Ā 000.00 |
R50Ā 000.00 |
R100Ā 000.00 |
R200Ā 000.00 |
R300Ā 000.00 |
R500Ā 000.00 |
R1Ā 000Ā 000.00 |
Estimated monthly purchases:Ā Ā Ā Ā Ā Ā
R10Ā 000.00-R20Ā 000.00 |
R30Ā 000.00-R50Ā 000.00 |
R100Ā 000.00-R200Ā 000.00 |
R300Ā 000.00-R500Ā 000.00 |
R1Ā 000Ā 000.00+ |
Ā
Applicant security offering:
Personal Surety |
Cession of Insurance Policy |
Cession of Debtor |
Property Guarantee |
National Bond over Stock |
Cross Company Guarantee |
Other Security (Specify) |
Ā
Ā
Signed at ___________________________Ā Ā on this dateĀ Ā Ā YYYY/MM/DD Ā Ā by (Print name): ________________________________
Ā
Signature (Applicant) _________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Director (Member): _____________________________Ā Ā
Ā
As witness Name: ___________________________Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā Witness signature: _____________________________
Ā Ā Ā Ā Ā Ā Ā Ā Ā Ā