Account Application

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Customer Company Details

Please complete this form to establish your account and also to ensure that we have the correct details for billing.

Full Company Details

Company Name (Legal Entity)* - required

Trading Name

Preferred Name

Legal Entity Trading Name

Full Street Address* - required

Suburb* - required

State* - required

Post Code* - required

ABN/ACN* - required

Invoicing Information

Company Name* - required

Invoice Receiver Name* - required

Full Street Address* - required

Suburb* - required

State* - required

Post Code* - required

PO Box (if applicable)

Suburb

State

Post Code

Invoice Receiver Contact Number* - required

Invoice Receiver Email Address* - required

Accounts Payable Information

Accounts Contact Number* - required

Accounts Email Address* - required

Purchase/Work Order Information

Is Purchase/Work Order Required* - required

Yes No

All Purchase/Work orders are to be sent to orders@bacs.com.au. Orders must be received before services can be performed.

I have read and agree to the website Privacy Policy.* - required

I agree for BACS to set up an account.* - required

I accept responsibility for all the details on this form.

Name* - required

Contact Number* - required

I have read and agree to the Service Terms and Conditions.* - required

Mandatory field(s) marked with *

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