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09 634 7674 customerservicenz@dixiecummings.com

Application for Credit with Supplier

DIXIE CUMMINGS NEW ZEALAND LIMITED
Company Number 2055371
(Supplier)

216 Roscommon Road, Wiri, 2104, Auckland
Tel: (00) 634 7674 Fax: (09) 634 7665

E-mail: ar@dixiecummings.com.au

Application for Credit with Supplier

Applicant Details

(The above entity is referred to as the Applicant in this application.  If the above entity is a partnership, or a trust with more than one trustee, the partners or trustees (as applicable) are also collectively referred to as the Applicant in this application)
Type of applicant
The maximum number of selections allowed is 1.

Corporate Trustee

Where the Applicant makes this credit application as trustee of a trust (whether or not it does so in any other capacity), it warrants and declares unconditionally to the Supplier that it has the power and authority to make and execute this application and that all rights of indemnity which it now has or may have in the future or may otherwise have against the property of the trust of which it is a trustee, have not been modified or excluded as a result of any act, matter of document made or executed by it or as a result of any breach of fiduciary duty or in any other way. It warrants and declares further that it has not released and shall not release in the future and shall not cause or permit to be released, lost or diminished in any manner whatsoever, any such right of indemnity.

Name of trustee:
Name of trustee:
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Name of settlor:
Name of settlor:
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Last
Address of trustee:
Address of trustee:
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Name of Main Director/Owner for contact:
Name of Main Director/Owner for contact:
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Last
Address for delivery of goods:
Address for delivery of goods:
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Address for delivery of mail (not a PO box):
Address for delivery of mail (not a PO box):
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As Above:
Address of business:
Address of business:
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As Above
Post Office Box:
Post Office Box:
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