Credit Account Application Form

To Be Completed By Applicants - Please complete all sections and read the Terms and Conditions of Trade overleaf or attached. This is a Credit Account Application Form under the Construction Contracts Act 2002. Please read clause 18 on the reverse.

Client's Details: *

IF Other:

Full or Legal Name: *

First

Last

Trading Name: (If different from above)

Email Address: *

Driver's Licence No:

Company Number:

Date Incorp. (current owners):

Nature of Business:

GST No: (if applicable)

Paid Up Capital: $

Estimated Monthly Purchases: $

Credit Limit Required: $

Principal Place of Business is:

IF Mortgaged (to whom):

(1) Full Name:

First

Last

(1) Driver's License No:

(2) Full Name:

First

Last

(2) Driver's License No:

Account Terms:

IF Other:

Purchase Order Required?

Accounts to be emailed?

Accounts Email Address:

Accounts Contact

Bank and Branch:

Account No:

1. Name

1. Email

2. Name

2. Email

3. Name

3. Email

Terms & Conditions *

I Agree to Terms & Conditions

Name *

First

Last

Position *

Click to Call Campbell Plumbing, Gasfitting and Drainlayers

Campbell Plumbing and Gasfitting

Certified Plumbers, Gasfitters and Drainlayers servicing Auckland Central, West Auckland, North Shore Auckland, and South Auckland.
For maintenance and emergency jobs call 0800 226 427 for urgent same day or ASAP service.

For small to large projects, call 0800 226 427 or email admin@campbellplumbing.co.nz to arrange a free quote.

Click to view our pricing guide, and residential and commercial projects.

OUR SERVICES:

Plumbing

How Water Systems

Gasfitting

Drainage

Pricing Guide

Call free today 0800 226 427

Name*
Email*
Phone*
Address*
Street Address City Suburb Postcode
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Suburb
Is this a project or maintenance enquiry?*
- Project
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Message*
Phone
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0800 226 427

admin@campbellplumbing.co.nz

Credit Account Application Form

Campbell Plumbing and Gasfitting

OUR SERVICES:

Plumbing

How Water Systems

Gasfitting

Drainage

Pricing Guide

We Accept

Contact Us