AGT206 AASC Application AV and PC

AGT206 AASC Application AV and PC

1. Type of business

(Sole Trader, Partner, Company, Trust)

Name of company: *required

Operating address:

Registered address:

Telephone *required

Mobile:

Fax: *required

Email: *required

Business Hours

2. Full name, private address and telephone number of all directors / partners / Proprietor.

1 :

Name: *required

Address: *required

Phone: *required

Name:

Address:

Phone:

Name:

Address:

Phone:

3. Details of Incorporation / Registration of business:

Cert/No.

Date:

Date Commenced:

A.C.N

A.B.N *required

BSB No. *required

ACC No. *required

Approved Overdraft: ($)

Paid up capital: ($)

Details of any securities. charges, etc. over assets:

Stock average level: ($)

Is the stock in any way encumbered:

If the stock is encumbered, please leave details:

Estimate of monthly credit requirement: ($)

4. Nature of Business:

What other business do you operate other than electrical repairs (eg. Retail sales, rental of appliances, video library, other).

Principle source of income of business (electrical repairs, retail sales, rentals, others):

5. Products repaired in our workshop:

Products repaired in our workshop: Audio VCR Plasma Projection Monitors DVD TV LCD TV PC/NB

5a. Service Areas / Districts / Suburbs

Postcodes: **Please separate postcodes with a comma e.g 2000, 2001, 2002

6. Trade reference

Please write name of company and person authorised to give a reference:

1.

Company:

Name:

Title:

Telephone:

Company:

Name:

Title:

Telephone:

Company:

Name:

Title:

Telephone:

If considered necessary, are you prepared to provide Director's guarantee (companies only):

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Mandatory field(s) marked with *required