New Account Application

New Account Application
(All details must be completed – Please print clearly)
Trading name:
a division of Penguin Australia Pty Ltd ABN 21 162 605 745
and distributing for Penguin New Zealand Pty Limited Company Number 4421800
Unit No: Street No: Street name: Suburb:
State (Aust. only): Country: Postcode:
Postal/Delivery address if different from above:
Buyer in your organisation:
Phone: Mobile: Fax:
Buyers email address:
Accounts contact in your organisation:
Phone: Mobile: Fax:
Accounts email address (your account statement will be emailed to this address unless otherwise advised):
Business Status: New Change of Ownership
If change of ownership please answer the following:
Changeover date: dd/mm/yyyy
/ /
Previous trading name:
Previous owner’s forwarding address:
Business Details:
Your business ownership is a: Company Trust Sole Trader Partnership
Registered company name or business name:
Date of incorporation (if applicable):
/ /
ACN & ABN (Aus.)/Registration No (NZ):
Other details:
Director/Proprietor’s full name:
Director/Proprietor’s full name:
Director/Proprietor’s full name:
Private address:
Private address:
Private address:
Private phone:
Private phone:
Private phone:
Date of birth: dd/mm/yyyy
/ /
Date of birth: dd/mm/yyyy
/ /
Date of birth: dd/mm/yyyy
/ /

Description of principal business activity:
Estimated value of monthly purchases through UBD:
$
Trade reference names: Phone:
1.
2.
3.
If a title is unavailable at the time of ordering how do you want the orders treated? (please tick box):
Record orders for all titles including new titles
Record orders for new titles only
Do not record any unavailable titles
For what purpose is your business purchasing product from UBD? ie. for re-sale, for use in a library, for promotional
purposes, etc. If for re-sale, please also indicate the medium(s) through which you will be selling our products.
Have you been in contact with a sales person prior to making this application, if so who? (please tick box):
Pearson Penguin Pearson Clinical and Talent Assessment Allen & Unwin Simon & Schuster New Holland
Sales Person’s Name:
Acknowledgement and Consent: I/we have received and read the ‘UBD Conditions of Sale’ published at www.unitedbookdistributors.com.au. I/
we agree that the Conditions automatically are part of this Application and are incorporated into all purchase orders and all contracts pursuant to this
Application.
Reporting to Credit Reference Agencies:
I understand and agree that Penguin may, in the event of difficulty in collecting debts due from me in relation to credit provided following this application,
notify Credit Reference Agencies of any defaults and my conduct in relation to the credit provided.
In making this application, I agree, in accordance with the provisions of the Privacy Amendment Act 1990, that under Section 18 of the Act that certain
items of personal information about me contained in this application is permitted to be kept on a credit information file and may be disclosed to a credit
reporting agency and the information referred to in the Act may occur for the purpose of assessing this application. I acknowledge that this shall continue
to have effect for the duration of any indebtedness to Penguin should this application be approved.
To enable this application to be processed all directors and/or individuals involved in the running/owning of this business must complete all sections of this
application, including Full Name, Current Address and Date of Birth.
Penguin’s Privacy Policy at www.unitedbookdistributors.com.au. I/we agree that Penguin may disclose and use personal information for its own purposes,
including to credit rating agencies, service providers, insurers and any other third parties in connection to any contracts formed pursuant to this
Application. Access to personal information on you held by Penguin can be arranged by contacting Penguin’s Privacy Co-Ordinator.
Authorised name and signature of applicant
Name:
Signature:
Completed application is to be emailed to accounts as shown below
Date: dd/mm/yyyy
/ /
Australia
United Book Distributors
a division of Penguin Australia Pty Ltd ABN 21 162 605 745
PO Box 23360 Melbourne VIC 8012
Email accounts@pearson.com.au Phone 1800 395 350 Fax +61 3 98112395
Website www.unitedbookdistributors.com.au
New Zealand
United Book Distributors
distributing for Penguin New Zealand Pty Limited Company Number 4421800
PO Box 112256 Penrose 1642 Auckland New Zealand
Email accounts@pearsonnz.co.nz Phone 0800 452 523 Fax +64 9 4427401
Website www.unitedbookdistributors.com.au
OFFICE USE ONLY
Discounts Education Penguin NHP Allen & Unwin Simon & Schuster PCTA
Representatives Education Penguin NHP Allen & Unwin Simon & Schuster PCTA
Classifications CC-TOB CC-BG CC-RTLNK
Accounts Limit Class Terms
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