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["Sensitive"]
[null,null,"NSW POLICE FORCE                                                                      "]
[null,null,"ABN 43 408 613 180",null,null,null,null,null,null,null,null,null,null,"Version 4.0 (12/17)"]
["New Customer Credit Application Form"]
["Full Company Name"]
["Trading Name"]
["Business Address",null,null,null,null,null,null,null,null,null,"Post Code"]
["Postal Address",null,null,null,null,null,null,null,null,null,"Post Code"]
["Telephone No",null,null,null,null,null,null,null,null,null,"Facsimile No"]
["Email Address"]
["Web site"]
["Business Type"]
["Entity Type (Sole Proprietor, Company, Partnership or Government):",null,null,null,null,null,null,null,null,null,"ABN No"]
["Date Business Commenced"]
["I / We hereby request that you open a 30 day Credit Account in my/our name for the supply of NSW Police."]
["Name of Directors  / Partners",null,null,null,null,null,null,null,null,"Position",null,null,"Phone"]
[1]
[2]
[3]
["Banking Details"]
["Bank Name",null,null,null,null,null,"Branch",null,null,null,null,"Phone:"]
["Address",null,null,null,null,null,null,null,null,null,null,"Post Code"]
["BSB No.",null,null,null,null,null,"Account No."]
["Trade References"]
["1. Company Name"]
["Address"]
["Contact Name",null,null,null,null,null,null,null,null,null,null,"Phone:"]
["2. Company Name"]
["Address"]
["Contact Name",null,null,null,null,null,null,null,null,null,null,"Phone:"]
["3. Company Name"]
["Address"]
["Contact Name",null,null,null,null,null,null,null,null,null,null,"Phone:"]
["Terms & Conditions"]
["Declaration (to be signed by an authorised person of the Company / Business applying for the credit Application)                                     I hearby state, as an authorised officer of the applicant Company/ Business, that the information provided above is true and accurate.                                                                                                                                                                                                                      I / We hereby authorise NSW Police Force to make any enquiries as it considers necessary to decide whether to accept this application.                                                                                                                                                                                                                     I / We understand that my/our signature on this application constitutes acceptance by the applicant of payment terms within 30 days.                                                                                                                                                                                                                                 I / We further accept liability jointly and severally with the applicant debtor, agree to pay any expenses, on a solicitor and client basis, incurred in the collection of monies which become overdue on my account."]
["Name of Applicant",null,null,null,null,null,null," Name of Witness"]
["Signature of Applicant",null,null,null,null,null,null," Signature of Witness"]
[]
["NSW Police Contact Officer/Event Coord.",null,null,null,null,null,null,null,null,"Location"]
[]
[]
["Email your signed completed form to as-accrecvble@police.nsw.gov.au or fax to: 02 8835 9062"]
[]
["NSW Police Force use only"]
["New Customer Created By:"]
["Name",null,null,null,null,null,null,"Signature"]
["Customer No",null,null,null,null,null,null,"Date"]
[]
[]
["Sensitive"]