Business Details
Principal Business Owner or Shareholder or Company Director
Other Partner / Director (2)
Other Partner / Director (3)
Other Partner / Director (4)
Other Partner / Director (5)
Trading History and References
Credit card surcharges may apply
Part 1 - Additional Information
I/We agree to promptly provide MyHealthConnected with such documents and information as MyHealthConnected may request (in the format required by MyHealthConnected) for the purpose of assisting MyHealthConnected in assessing this application for trade credit (Application).
Part 2 - Contents of Application
(a) I/We represent and warrant that as at the date this Application is submitted to MyHealthConnected and as at each day that credit is provided to me/us by MyHealthConnected, the contents of this Application together with any financial statements submitted with this Application are complete, true and correct in every particular and are not misleading or deceptive in any way. (b) I/We undertake to immediately notify MyHealthConnected in writing as soon as I/we become aware of any matter or thing which renders or may render any item described in clause (a) incomplete, untrue, incorrect, misleading or deceptive. (c) MyHealthConnected may in its absolute discretion accept or reject this Application and to the maximum extent permitted by law, is under no obligation to provide reasons for any such rejection. (d) I/We acknowledge that I/we must not use any Goods or credit provided by MyHealthConnected wholly or predominantly for personal, domestic or household use. wholly or predominantly for personal, domestic or household use.