Supplier Form – Central Coast

Legal Entity Name*

Trading Name (if different to above)

Do you have an ABN*

Yes
No

ABN*

Please enter your 11-digit ABN with no spaces

Statement by Supplier*

If ABN is not applicable, please complete an ATO Statement by a Supplier Form indicating reason for not quoting an ABN. Download a form from here, complete the form and then upload it here

Max. file size: 8 MB.

Business Address*

Enter in your address and then select from the dropdown

Address line 1 Address line 2 Town/Suburb State Postcode

Do you have a different mailing address*

Yes
No

Mailing Address*

Address line 1 Address line 2 Town/Suburb State Postcode

Business Phone Number*

Supplier Contact Name*

Supplier Contact Position*

Supplier Contact Phone Number*

Supplier Contact Mobile Number*

Supplier Contact E-mail*

Accounts Receivable Contact Phone Number*

Accounts Receivable Contact Name*

Accounts Receivable Contact E-mail*

Purchase Order Contact E-mail*

Market Segment*

Please select appropriate segment

Bank Account Details

Bank*

Branch*

Account Name*

BSB # (6 digits)*

Please enter 6 digits

Bank Account #*

Please provide a copy of a recent bank statement (remove dollar amounts from statement) or a bank deposit slip which includes the bank account details*

Max. file size: 8 MB.

Please note our payment terms are 30 days from End of Month

To the extent VenuesLive collects or handles Personal Information in this request for information, VenuesLive agrees it will comply with: (a) all applicable laws relating to privacy and the processing of Personal Information, including without limitation the Privacy Act; and (b) VenuesLive’s privacy policy as amended from time to time and as available here.

Please confirm

Name

This field is for validation purposes and should be left unchanged.