New customer form

Your name *

Your contact number *

Your Email *

Company name *

Address *

City *

State *

Post code *

ABN *

ABN

Billing contact name *

Billing Email *

Billing contact number *

Payment terms - We will require a credit card on file before performing any work - we will contact you about this once we receive this form. *

You MUST agree to this

Collection of Information I understand that all personal information collected by Phonetex concerning me (including the information collected in this form) is collected and may be stored, used or disclosed in order to determine whether or not Phonetex will provide or continue to provide credit to me or my organisation, and enforce any obligations I or my organisation may have to Phonetex in respect of that credit, including but not limited to registering a Financing Statement in accordance with Phonetex’s rights under the Personal Properties Securities Act 1999. The personal information will be held by Phonetex at the address shown above. I understand that I have the right as a sole trader, partnership, trustee or as a director of a company to obtain access to and request correction of the information provided in accordance with the Privacy Act 1993. I authorise Phonetex to obtain any personal information concerning me that Phonetex considers is necessary for the above purposes from any person or organisation. I authorise any person from whom Phonetex requests personal information concerning me to release that information to Phonetex. I also authorise Phonetex to release my personal information to any person for the purposes of determining credit worthiness, for communicating promotional activities and product information and for debt collection purposes *

You MUST agree to this