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Accounts Application.
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If you are requesting Credit on behalf of a Corporation or Sole Trader it is a requirement that you provide us with the following signed documents in addition to the preliminary online application form. The online form enables the initialisation of establishment procedures.

Simply sending an Account Application does not give the sender an immediate credit account.

Accounts will only be made available to organisations that have completed the Account Application in full and the complete approval process has been administered.

 

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Application Form

If you are interested in becoming a registered Auto Xtreme Dealer, complete the form below and one of our consultants will be in contact with you.

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Business Details:
Business Name:
Trading name:
ACN/ABN:
(Please complete the Company Name, Incorporation Date and Registered Office if applicable. If not applicable, please enter NA)
Company Name:
Incorporation Date:
Registered Office:
Business Address:
Telephone:
Fax:
Email:
Partnership:  Sole Trader:  Company:
Industry:
Year Commenced:
Bank:
Branch:

Directors / Partners / Sole Trader Details
Name Address

Trade References
(minimum of 3 active trading accounts required)
Name Phone Number
            
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AutoXtreme - The Automotive Electronic Specialists | Tel: 07 3711 2222 | Fax: 07 3711 2200 | Copyright 2004 AutoXtreme