Tyregrow Limited – Account Application

Please complete all required fields. Approval is subject to credit assessment.

1. Applicant Details

Registered Company Name *

Trading Name (if different)

Company Number

NZBN

Postal Address *

Post Code *

Delivery Address (if different)

Phone

Mobile

Email Address *

Nature of Business

Years in Operation

Business Structure *
Limited CompanyPartnershipSole TraderOther

If Other, please specify

Is a Purchase Order Number Required?
YesNo

2. Directors / Partners / Owners

Provide full legal names, residential addresses and contact numbers of all directors, partners or proprietors.

Details *

3. Trade Credit References

Please provide at least two current trade references.

Reference 1
Business Name

Reference 2

Reference 3 (optional)

4. Authorisations & Declarations

By submitting this application, you confirm that:

• The information provided is true and correct.
• You are authorised to apply for credit on behalf of the applicant.
• You consent to Tyregrow Ltd conducting credit checks.
• You agree to be bound by Tyregrow Ltd’s Terms & Conditions of Trade.

Authorised Signatory Name *

Date of Birth *

Date *

5. Personal Guarantee (If Required)

Is a Personal Guarantee Required?
YesNo

Guarantor Full Name

Guarantor Residential Address

Guarantor Signature (Type Full Name)

Witness Name

Witness Occupation

Witness Address

Date

6. Final Acceptance

Customer Company Name *

Applicant Name *

Position

Signature (Type Full Legal Name) *

Date *

I hereby affirm that the information provided is correct and true to the best of my knowledge.
I confirm that I have read and agree to the Terms & Conditions of Trade .

Submit Application