Public Share Holder
Private Share Holder
Company
Estabishment
Sole Trader
Business
Name/Trading Name Company Name
Registration Number
Date Of Incorp Date Business
Commenced Operation Date Business
Purchased by Current Owners Occupation
From To
Company Name Suburb
City No. of cards required
*(if not applicant/s) Additional cardholder application required.
CONTACT NUMBERS
Own/Buying
Leased /Rent
___________________________________P/Code:_________________
Years/Months at this address
:_______________________________________________________________
Previous addresses of business (5 years) 1-______________________
From:_______ To:__________ 2- ____________
______________ From:_______ To__________
No.
of Outlets (NB)List
address in additional information
Products /Services available on
Trade
1-
2-
3- 4-
Trade
References
Business
Name
Suburb
Contact
Name
Phone
Number
Does
your business trade under any other name with these references? If
"Yes" please list____________________________ Company
Directors /Partners
/Proprietors:__________________________________________________
Family
Name
Given
Name
Residental
Address
Rent/Buy
Phone
Number
If
less than five (5) years at current address ,give previous address
details.(SIGNING APPLICANT OR MANAGING DIRECTOR)
Address
State /Country
Years/Months Company Accountant
Phone: ( ) Details of
nearest relative Name:
Relationship:
Phone: ( )Address:
Financial
Information * This section must be completed if applying for Trade
Dinar facility .
Assets
Liabilities
Estimated
Company
TurnOver
Stock,Plan
& Equipment _______JD
Overdraft
_______________JD
Current
turnover p.a.______JD_______________
Commercial/Investment
________JD
Bank
Loans _____________JD
Previous
turnover p.a.______JD_______________
House
Residential____________ JD
Home
Loans ____________JD
Previous
turnover p.a.______JD_______________
Motor
Vehicle ______________JD
Credit
Cards ____________JD
JD
Total
JD:
Total
JD:
Total
JD:
I/we
have read and understood the particulars which have been completed in
this application and state that these particulars are true and
complete and have been made to Swap Net Co. to enable it to determine
whether to approve this application . I/We hereby appoint Swapnet Co.
as my/our agent for the purposes of ascertaining personal information
from my trade credit references with respect to my credit worthiness.
I/We agree to Swapnet co. obtaining from a credit reporting agency , a
credit report containing personal credit information about me/us in
relation to commercial trade dinar facility provided by Swapnet Co.
Name of Applicant Position
/Title:
National ID Number Date of Birth
Signature Date
Account Name
Date :
I / we the undersigned hereby authorize SwapNet Co. to deduct the
monthly cash service fees from my ...........................
National Express
Master Card
Visa Card
Diners
American Expres
4.
I and all my additional card holders hereby agree : a) to be bound by
the terms and conditions of swap net membership agreement ; b) swapnet
may , in its sole discretion , change the terms of the agreement from
time to time by giving member seven ( 7) days prior written notice .
Purchase or sale after seven (7) days notice period constitutes
acceptance of the new terms . All changes to this agreement must be in
writing and signed by the managing director or general manager of swap
net . such notice shall be sent by mail to members business address .
5.
I/We hereby acknowledge that the swapnet trading rules and regulations
are considered an integral part of this agreement and have been
received , read and approved from our part . Name Of Applicant
Name Of Applicant Position
Position Signature
Signature Date
Date
Authorized Signatory of Swap Net
Jordan Date
Director's
Guarantee
In
consideration of swap net , at the request of the undersigned entering
into the above membership agreement ("the Agreement " ) the
undersigned (jointly and severally ) hereby agree to be jointly and
severally liable for payment of all purchases and fees outlined in the
agreement , and further hereby to guarantee the repayment of all debts
and liabilities of the member arising from the agreement . This
guarantee shall always be a continuing guarantee and shall continue in
full farce and effect until all liabilities of the member shall be
fully paid and satisfied and each of the undersigned will at all times
hereafter indemnify shall extend against all actions, suits,
proceedings , claims , demands, costs , and expenses whatsoever which
may be taken against swap net co. or incurred or become payable by
swap net in respect thereof . Director's Name
Director's Name Signature
Signature Name of Witness
Name of Witness Signature
Signature Date
Date
Sales
Consultant's Notice / Additional Information
Number of employees
/size of business
Are there other key staff
involved ? Who ?
Hobbies & Interests
Identified
Do they operate other businesses
? What_____________________________
