Direct Credit Application Form

This application is intended for Business and Organizations that meet our On Invoice conditions rather than paying by credit card which is the preferred and most convienent method.

By completing this application you agree that if it is accepted the following conditions will form extra obligations in addition to the Standard Terms of Use:

Invoices are due for payment on the 20th of the month following the invoice
Cancelling your Subscription ; You agree to giving 12 months notice period on ending your contract and waive the 30 days notice provision under clause 7.1 of the Terms of Use

Applicant Details

Legal Entity / Organisation Name

PeopleSafe Account Number

Position

First Name

Last Name

Email

Phone

(###)

###

####

Authorised Person

I am Authorised on Behalf of the Subscriber to bind the company to these Additional Terms which are in addition to the Terms of Use found at www.peoplesafe.com/terms-of-use.

Yes, I confirm I am authorized to agree to these additional Terms

Digital Signature of above listed person

Date

MM

DD

YYYY

IMPORTANT NOTES

By submitting this form you confirm the following.

You are Authorised on Behalf of the Subscriber to bind the company to these Additional Terms which are in addition to the Terms of Use found at www.peoplesafe.com/terms-of-use.

By digitally signing and returning this Application, You:

1. Understand that PeopleSafe Ltd (“Us/Our/We”) reserves the right to decline this Application.

2.Confirm that the information supplied by You in this Application is correct and complete and You agree to immediately advise Us of any material change of any of the information contained in this Application.

3. You have read and understood Our standard Terms of Use (“Terms”) included with this Application and agree to be bound by them (including any variations or replacement) and this Application.

4. Agree that all orders for goods (being the goods described on the invoices) placed with Us are supplied on these Terms.

5. Authorise any person or company to provide the Supplier with such credit information as we may require You.

6.Authorise the Supplier to collect personal information about You from the credit reference agencies We use. You acknowledge that such information is collected for any purpose connected with my/our business, for considering this Application and for all purposes in connection with the Supplier marketing of products and services in New Zealand. I/We consent to the Supplier disclosing any such information to credit reference and debt collection agencies as part of information exchanges with them. I/We acknowledge that my/our rights at law in relation to obtaining and correcting all information about me/us held by the Supplier are not affected.