Online Trading Application

BUSINESS INFORMATION *Business Name: *Billing Address 1: Billing Address 2: Billing Address 3: Billing City: Billing State: Select your State Aust.Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia International - (Enter country after your city name) Billing Post Code: *Billing Address is: Commercial Residential   *Shipping Address 1:   (If shipping address same as billing address, enter "SAME") Shipping Address 2: Shipping Address 3: Shipping City: Shipping State: Select your State Aust.Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia International - (Enter country after your city name) Shipping Post Code: *Shipping Address is: Commercial Residential *Telephone: Fax: *Email: *Email (confirm): *Australian Business Number: *Business hours: *Date Business First Opened: *Contact Name & Title: Authorized Buyers: *1. 2. 3. *Business Form: Sole Owner Partnership Franchise Corporation *Annual Sales: under $25,000 $25,000-100,000 $100,000-$500,000 $500,000 + *Location: Shopping Centre Strip Shop Residence Rural Other: *Type of Business: Craft/Variety/Hobby Chocolate/Candy Shop Bakery Manufacturer Other: Sales & Use Information *This is to certify that all purchases by the undersigned from Taylored Treats will be purchased for the following purpose: For sale as a tangible personal property in the same form as received To be incorporated as a material, ingredient or component of a new product produced for sale by manufacturing, assembling, processing or refining To be exported for sale, use or consumption outside the continental limits of Australia To be sold outside sellers state This certificate shall be considered part of each order we shall hereinafter place and shall be applicable to any property purchased by the undersigned unless otherwise specified, and shall remain in force until revoked in writing. List at least 1 Owner, Partner or Principal Officer (if more information is required it will be requested) *Name: *Home Address: *City/Suburb: *State: ACT NSW NT QLD SA TAS VIC WA INT'L *PostCode: *Home Telephone: Mobile Phone Number:     By submitting this form, I certify that this information is true and correct to the best my knowledge and understand that this application is for trading purposes only and by no means infers that credit terms will be provided. *NAME & TITLE OF PERSON COMPLETING FORM:

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