Please note - You will need your ABN, details of each owner or director, and a current Australian driver license. Required fields are marked *with an asterisk. Business detailsTrading name*Company or trust nameIf different from the trading name.ABN*ACNContact name*Trading address*Email*Phone*Accounts contactThe person or third-party company that processes your invoices and payments. Invoices and statements go to this email.Contact name*Email*PhoneBilling addressLeave blank if it is the same as the trading address.Owners and directorsFull name and private address of each director, proprietor or partner.Owner 1Remove owner 1Role*Select…DirectorProprietorPartnerFull name*Phone*Private addressOwner Remove owner Role*Select…DirectorProprietorPartnerFull name*Phone*Private address+ Add another ownerTrade referencesOther suppliers you hold trade accounts with.Reference 1Remove reference 1Company*Phone*Reference 2Remove reference 2Company*Phone*Reference Remove reference Company*Phone*+ Add a referenceDeclarationTo be signed by an owner or director with authority to apply on behalf of the business.By signing below, you affirm that the information you have provided in the application to be true and complete to the best of your knowledge. I/We the undersigned, declare to have the authority of application on behalf of the proprietor specified above.All orders placed by and invoiced to the proprietor/s specified above remain the contractual responsibility for payment. I/We understand that all orders remain the property of Grant Walker Motors P/L until full payment has been made.I/We understand and agree to pay within agreed terms of our/my credit account, and understand that if I/We exceed our/my account terms the account will be placed on 'stop credit' till the account is put back into arrears.I/We acknowledge that should the debt be passed onto a third party for debt recovery purposes, any fees or commissions will be added to the overdue amount.First name*Middle namesSurname*Driver licence number*State of issue*Select…VictoriaNew South WalesQueenslandSouth AustraliaWestern AustraliaTasmaniaAustralian Capital TerritoryNorthern TerritoryLicence expiry*Signature*Sign with your finger or mouse.Date 3 November 2026Clear signatureType your name insteadType your full name to signYour name above and the checkbox below will act as your signature.I accept the terms and conditions of the account* Leave this field empty Submit application We use these details to assess your application. Read our privacy statement.
