COMPANY DETAILS
Company name: .............................................................................................................................................................................
Company Registration Number: ...................................... Tax Registration Number: ………………………………………………..
Years in Business: ........................ Company Type: Public / Private (circle)
Company Website ................................................................................................................................
IF ORGANISATION IS A SOLE TRADER / PARTNERSHIP / TRUST / OTHER (circle)
Proprietor / Partnership / Trust Name: ..............................................................................................................................................
Trading as: ..............................................................................................................................
INFORMATION REQUIRED FOR ALL RESELLERS
Invoice Address: ................................................................................................................................
Country:………………………………………… Post Code: ..........................
Business Address: ..............................................................................................................................
Country:………………………………………… Post Code: ..........................
Is Business Address: Owned / Rented (circle) If Owned, Does Mortgage Exist? Yes / No (circle)
Main Phone Number: ...................................................... Email Address for Invoices: .......................................................................
Delivery Address: ...............................................................................................................................
Country:………………………………………… Post Code: ..........................
Special Delivery Instructions: ...........................................................................................................................................................
......................................................................................................................................................................................................
Number of Employees: ................. Default for Shipments: Part Ship / No Part Ship (circle)
Booking / Authorised Officer Contact: .............................................................. Email Address: ........................................................
Direct Phone Number (Include Country Code): ……………………………………………………….
Accounts Payable Contact: .............................................................................. Email Address: ........................................................
Direct Phone Number: ……………………………………………………….
Banking Details – Bank Name: .................................................... Bank Address: ..............................................................................
Bank Contact: ............................................................................ Bank Phone Number: ....................................................................
Facilities Granted: Secured Term Loan / Unsecured Term Loan / Fixed Deposit / Letter of Credit / Overdraft (Circle all applicable)
Key Personnel: Directors / Proprietors / Partners (circle)
1. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
2. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
3. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
4. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
If additional key personnel exist, please tick here ....... and attach a separate schedule.
Have any of the Directors / Proprietors / Partners been declared bankrupt or involved with any insolvency? Yes / No (circle)
Other Directorships Held by Key Personnel during the Past 5 Years
1. Key Person Name: ................................................................ Company Name: .........................................................................
Company Registration Number: ………………………………………………
2. Key Person Name: ................................................................ Company Name: .........................................................................
Company Registration Number: ………………………………………………
3. Key Person Name: ................................................................ Company Name: .........................................................................
Company Registration Number: ………………………………………………
If additional directorships are / were held during this period, please tick here ....... and attach a separate schedule.
Company Category: System Integrator / Service Provider / Value Added Reseller / Direct Marketers (circle)
Trade References - Major Suppliers
1. ........................................................................................................ Average Monthly Spend with this Supplier: .......................
Phone: ................................................. Email: ........................................................................
2. ........................................................................................................ Average Monthly Spend with this Supplier: .......................
Phone: ................................................. Email: ........................................................................
3. ........................................................................................................ Average Monthly Spend with this Supplier: .......................
Phone: ................................................. Email: ........................................................................
Anticipated Monthly Purchases with Westcon Group: ....................................
Credit limit amount requested with Westcon Group: .....................................
Company Year-End Date: ............................................
Please attach your most recent 2 years Profit and Loss Statement and Balance Sheet to this application and send to WGAP Credit Management WGAPCreditManagement@westcon.com
Are your year-end financial statements audited? Yes No (circle)
The reseller will be notified by Westcon Group, Inc. if Directors’ guarantees are required to support this application.
Authorisation
We, the undersigned, authorise Westcon Group, Inc., its affiliates and subsidiaries (Westcon) to conduct the references provided in this credit application for the purposes of establishing a credit facility. We authorise the referees listed to disclose all details necessary to Westcon. We certify that all the information provided in this credit application is true and correct. We certify that we are authorised to enter into, and sign this credit applications on behalf of the company listed below.
Acknowledgment of Terms and Conditions of Sale
We agree to be bound by Westcon’s terms and conditions of sale, as amended from time to time, at the following URL: http://au.westcon.com/content/overview/overview/terms-conditions/sales (Terms and Conditions). We warrant that we have read the Terms and Conditions and accept that:
(a) a reference to an explicit Westcon entity is replaced by the Westcon entity that we are placing an order on;
(b) references to specific laws, regulations and rules are replaced by the equivalent laws, regulations and rules in the territory that we conduct business within; and
(c) if any provision is held by a court of competent jurisdiction to be invalid or unenforceable, the remaining provisions will remain in full force and effect, and shall be construed so as to best effectuate the intention of the parties in executing it.
If the persons signing are trustees or an authorised representative of a company –
We agree to produce a stamped copy of the trust deed, with all amendments, if and when requested by Westcon. We warrant that we have the full power and authority to enter into this agreement on behalf of the trust and/or the company. In the case of a trust, we shall be bound by the Terms and Conditions, both personally and as trustees, irrespective of whether or not we or the trust disclose to Westcon that we are trustees at the time of entering into this credit agreement with Westcon.
___________
COMPANY DETAILS
Company name: .............................................................................................................................................................................
Company Registration Number: ...................................... Tax Registration Number: ………………………………………………..
Years in Business: ........................ Company Type: Public / Private (circle)
Company Website ................................................................................................................................
IF ORGANISATION IS A SOLE TRADER / PARTNERSHIP / TRUST / OTHER (circle)
Proprietor / Partnership / Trust Name: ..............................................................................................................................................
Trading as: ..............................................................................................................................
INFORMATION REQUIRED FOR ALL RESELLERS
Invoice Address: ................................................................................................................................
Country:………………………………………… Post Code: ..........................
Business Address: ..............................................................................................................................
Country:………………………………………… Post Code: ..........................
Is Business Address: Owned / Rented (circle) If Owned, Does Mortgage Exist? Yes / No (circle)
Main Phone Number: ...................................................... Email Address for Invoices: .......................................................................
Delivery Address: ...............................................................................................................................
Country:………………………………………… Post Code: ..........................
Special Delivery Instructions: ...........................................................................................................................................................
......................................................................................................................................................................................................
Number of Employees: ................. Default for Shipments: Part Ship / No Part Ship (circle)
Booking / Authorised Officer Contact: .............................................................. Email Address: ........................................................
Direct Phone Number (Include Country Code): ……………………………………………………….
Accounts Payable Contact: .............................................................................. Email Address: ........................................................
Direct Phone Number: ……………………………………………………….
Banking Details – Bank Name: .................................................... Bank Address: ..............................................................................
Bank Contact: ............................................................................ Bank Phone Number: ....................................................................
Facilities Granted: Secured Term Loan / Unsecured Term Loan / Fixed Deposit / Letter of Credit / Overdraft (Circle all applicable)
Key Personnel: Directors / Proprietors / Partners (circle)
1. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
2. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
3. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
4. Name in Full: ............................................................................................................. Date of Birth: ........................................
Residential Address: ........................................................................................................................
Country:…………………………………………Post Code: ..........................
If additional key personnel exist, please tick here ....... and attach a separate schedule.
Have any of the Directors / Proprietors / Partners been declared bankrupt or involved with any insolvency? Yes / No (circle)
Other Directorships Held by Key Personnel during the Past 5 Years
1. Key Person Name: ................................................................ Company Name: .........................................................................
Company Registration Number: ………………………………………………
2. Key Person Name: ................................................................ Company Name: .........................................................................
Company Registration Number: ………………………………………………
3. Key Person Name: ................................................................ Company Name: .........................................................................
Company Registration Number: ………………………………………………
If additional directorships are / were held during this period, please tick here ....... and attach a separate schedule.
Company Category: System Integrator / Service Provider / Value Added Reseller / Direct Marketers (circle)
Trade References - Major Suppliers
1. ........................................................................................................ Average Monthly Spend with this Supplier: .......................
Phone: ................................................. Email: ........................................................................
2. ........................................................................................................ Average Monthly Spend with this Supplier: .......................
Phone: ................................................. Email: ........................................................................
3. ........................................................................................................ Average Monthly Spend with this Supplier: .......................
Phone: ................................................. Email: ........................................................................
Anticipated Monthly Purchases with Westcon Group: ....................................
Credit limit amount requested with Westcon Group: .....................................
Company Year-End Date: ............................................
Please attach your most recent 2 years Profit and Loss Statement and Balance Sheet to this application and send to WGAP Credit Management WGAPCreditManagement@westcon.com
Are your year-end financial statements audited? Yes No (circle)
The reseller will be notified by Westcon Group, Inc. if Directors’ guarantees are required to support this application.
Authorisation
We, the undersigned, authorise Westcon Group, Inc., its affiliates and subsidiaries (Westcon) to conduct the references provided in this credit application for the purposes of establishing a credit facility. We authorise the referees listed to disclose all details necessary to Westcon. We certify that all the information provided in this credit application is true and correct. We certify that we are authorised to enter into, and sign this credit applications on behalf of the company listed below.
Acknowledgment of Terms and Conditions of Sale
We agree to be bound by Westcon’s terms and conditions of sale, as amended from time to time, at the following URL: http://au.westcon.com/content/overview/overview/terms-conditions/sales (Terms and Conditions). We warrant that we have read the Terms and Conditions and accept that:
(a) a reference to an explicit Westcon entity is replaced by the Westcon entity that we are placing an order on;
(b) references to specific laws, regulations and rules are replaced by the equivalent laws, regulations and rules in the territory that we conduct business within; and
(c) if any provision is held by a court of competent jurisdiction to be invalid or unenforceable, the remaining provisions will remain in full force and effect, and shall be construed so as to best effectuate the intention of the parties in executing it.
If the persons signing are trustees or an authorised representative of a company –
We agree to produce a stamped copy of the trust deed, with all amendments, if and when requested by Westcon. We warrant that we have the full power and authority to enter into this agreement on behalf of the trust and/or the company. In the case of a trust, we shall be bound by the Terms and Conditions, both personally and as trustees, irrespective of whether or not we or the trust disclose to Westcon that we are trustees at the time of entering into this credit agreement with Westcon.
___________
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