Account Application Please Fill in the application Below: ABNCompany NameTrading/asDelivery Address for MilkPostal Address.Email for Accounts Contact personContact phoneRough order // Milk requirementAny Special information about the deliveries / date and time etcCredit reference // Not needed for NT GovNameContactNumber Please Fill In Any Credit references. Not needed for government Terms: Payment within seven (7) days from date of Invoice 1: The Customer agrees to settle in full all accounts rendered by the Supplier (Dewa (NT) Pty. Ltd.) in accordance with the terms. 2: The customer agrees to indemnify the Supplier (Dewa (NT) Pty. Ltd.)for all costs and commissions, legal expenses and miscellaneous expenses incurred by the Supplier (Dewa (NT) Pty. Ltd.) however arising from the collection of any monies due by the customer to the Supplier (Dewa (NT) Pty. Ltd.) 3: The customer agrees that should the customer be in breach of clause ONE (1) hereof, an overdue account fee of 10% per month on the balance owing will accrue to its account and become payable on demand. 4: The customer agrees to supply the forgoing information and warrants the above information to be true and correct in every detail. 5: The customer warrants that the customer is not bankrupt, insolvent or under any scheme of management at the time of making this agreement. 6: The customer hereby acknowledges receipt of copies of this agreement and agrees to be bound by the terms herein NameThis will count as electronic SignatureCAPTCHAConsent* I agree to the above