Credit Application

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Step 1 of 8 - 1. Applicant Details

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Name Of Applicant*

First Last

Trading Name (If Applicable)

Physical Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Applicant Email Address*

Fax Number

Company Registration*

Quoted Company

Public Company

Private Company

Closed Corporation

Partnership

Sole Ownership

Registration Number*

VAT Number*

Date of Registration / Incorporation / Establishment

Customs Code*

Initial*

1. Company Name*

1. Contact Person*

Average Monthly Spend With Supplier*

Physical Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2. Company Name*

2. Contact Person*

Average Monthly Spend With Supplier*

Physical Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

3. Company Name*

4. Contact Person*

Average Monthly Spend With Supplier*

Physical Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please provide details of any Security Previously Given (Cession of Book Debts, Mortgage Bonds, Personal Guarantees, etc.) (Nature of Security, Amount, Beneficiary)*

Name Of Present Clearing Agent*

Are Audited Financial Statements Available?*

Yes

Amount Of Credit Required*

Payment Terms

Initial*

The Company reserves the right, at any time, to discontinue any account and summarily to cancel any credit facilities granted. In the event of these rights being exercised all amounts owing shall immediately become due and payable on demand.
It is acknowledged, that should payments not conform to the terms agreed, interest may be charged on any amount overdue at the maximum rate of interest allowed.
1. The Applicant agrees that should it be in default in meeting its payment terms that the Company shall on its behalf and notwithstanding that the amount of its claim or the nature of the relief sought by it exceeds the jurisdiction of the Magistrates Court, be entitled to institute action out of such Court.
2. Notwithstanding the provisions of 3a) the Company shall be entitled, in its sole discretion, to institute proceedings against the applicant out of the Supreme Court of South Africa (South Gauteng High Court) to whose jurisdiction the Applicant hereby submits.
3. In the event of the Company referring any dispute between it and the Applicant, or any amount due for the collection from the Applicant to it, to its Attorneys the Applicant shall be liable to and hereby indemnifies and the Company against all costs, charges and expenses incurred as between Attorney and his client and such indemnity shall extend to and include collection commission as may be lawfully charged to the Company by its Attorneys.
4. By undersigning this application form, the members/directors are prepared to sign personal guarantees.
The Applicant hereby acknowledges that the Company's Standard Trading Conditions have been specifically brought to their attention and agrees and accepts the terms stated therein and that all business conducted between the Company and the Applicant will be conducted in terms of such Standard Trading Conditions by which he agrees to be bound.
This agreement shall be of full force and effect from the date that any business is transacted between the Applicant and the Company. The signatory hereunder warrants that the information entered on this document is true and correct.

The Company reserves the right, at any time, to discontinue any account and summarily to cancel any credit facilities granted. In the event of these rights being exercised all amounts owing shall immediately become due and payable on demand.
It is acknowledged, that should payments not conform to the terms agreed, interest may be charged on any amount overdue at the maximum rate of interest allowed.
1. The Applicant agrees that should it be in default in meeting its payment terms that the Company shall on its behalf and notwithstanding that the amount of its claim or the nature of the relief sought by it exceeds the jurisdiction of the Magistrates Court, be entitled to institute action out of such Court.
2. Notwithstanding the provisions of 3a) the Company shall be entitled, in its sole discretion, to institute proceedings against the applicant out of the Supreme Court of South Africa (South Gauteng High Court) to whose jurisdiction the Applicant hereby submits.
3. In the event of the Company referring any dispute between it and the Applicant, or any amount due for the collection from the Applicant to it, to its Attorneys the Applicant shall be liable to and hereby indemnifies and the Company against all costs, charges and expenses incurred as between Attorney and his client and such indemnity shall extend to and include collection commission as may be lawfully charged to the Company by its Attorneys.
4. By undersigning this application form, the members/directors are prepared to sign personal guarantees.
The Applicant hereby acknowledges that the Company's Standard Trading Conditions have been specifically brought to their attention and agrees and accepts the terms stated therein and that all business conducted between the Company and the Applicant will be conducted in terms of such Standard Trading Conditions by which he agrees to be bound.
This agreement shall be of full force and effect from the date that any business is transacted between the Applicant and the Company. The signatory hereunder warrants that the information entered on this document is true and correct.

Initial*

Please click here to read a full set of of Atrax Commerce (Pty) Ltd Standard Trading Terms and Conditions.

Choose An Option*

I hereby agree to have read and understood and accept Atrax Commerce (Pty) Ltd Standard Trading Terms and Conditions

I hereby agree to have read and understood Atrax Commerce (Pty) Ltd Standard Trading Terms and Conditions, however, I want to make alterations to the Standard Trading Terms and Conditions which I will strike through and initial next to the conditions in order to confirm the same

Agreement

By singing this Electronic Signature Acknowledgement Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature and hereby confirm that I have read al the terms and conditions of this credit application.

The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature of such party and shall be effective to bind such party to this Agreement, I*

First Last

with ID / Passport Number*

and Designation*

confirm that I am authorized to sign and act on behalf of the company.
The parties agree that any electronically signed document (including this Agreement) shall be deemed (i) to be “written” or “in writing,” (ii) to have been signed and (iii) to constitute a record established and maintained in the ordinary course of business and an original written record when printed from electronic files. Such paper copies or “printouts,” if introduced as evidence in any judicial, arbitral, mediation or administrative proceeding, will be admissible as between the parties to the same extent and under the same conditions as other original business records created and maintained in documentary form. Neither party shall contest the admissibility of true and accurate copies of electronically signed documents on the basis of the best evidence rule or as not satisfying the business records exception to the hearsay rule. For purposes hereof, “electronic signature” means a manually-signed original signature that is then transmitted by electronic means; “transmitted by electronic means” means sent in the form of a facsimile or sent via the internet as a “pdf” (portable document format) or other replicating image attached to an e-mail message;

CERTIFICATION OF UNDERSTANDING; I also understand, acknowledge, agree and certify that:

I accept my responsibilities in the use of electronic signatures as described in this form.
I am the legal and authorized person on behalf of the company stated herein, to sign off this credit application and standard trading terms and conditions.

Signed (Please sign below with your mouse)*

Date of Appointment*

Signed At (Place Of Signature)*