Engineering Computer Services Ltd
                                                                                                                  Cnr Te-Rapa & Ruffell Rd
                       Account Application Form                                                                           Hamilton, 3200
                                                                                                                             New Zealand
                                                                                                                    Sales: 0800 849 2211
                                                                                                                         Tel: 07 849 2211
                                                                                                                        Fax: 07 849 2220
                                                                                                                          www.ecsnz.com
                       To apply for a credit account, please complete the following forms and return them back to us.
                       Customers Trading Name                               ………………………………………………….…………….…………….
                       Business Address                            Name ………………………………………………….
                                                                   Street   ………………………………………………….
                                                                   Suburb ………………………………………………….
                                                                   City     ………………………………………………….
                                                                   Zip Code………………………………………………….
                                                                   Country ………………………………………………….
                       Postal Address                              PO Box ………………………………………………….
                                                                   Suburb ………………………………………………….
                                                                   City     ………………………………………………….
                                                                   Zip Code………………………………………………….
                                                                   Country ………………………………………………….
                       ABN or NZ Company Number                             ………………………………………………….
                       Business Phone Number                                ………………………………………………….
                       Key Contact Details                         Name  ………………………………………………….
                                                                   Email    ………………………………………………….
                                                                   Position ………………………………………………….
                       Accounts Email Address                               ………………………………………………….
                       Type of Business                                     ………………………………………………….
                       Name of Managing Director                            ………………………………………………….
                                                                                                      Engineering Computer Services Ltd
                                                                                                                     Cnr Te-Rapa & Ruffell Rd
                                                                                                                               Hamilton, 3200
                                                                                                                                 New Zealand
                       Trade References                                                                                 Sales: 0800 849 2211
                                                                                                                             Tel: 07 849 2211
                       For trade references, please do not include utilities (ie Power and Phone services).                  Fax: 07 849 2220
                                                                                                                              www.ecsnz.com
                                                                              1) ………………………………………………….
                                                                              Phone……………………………………………
                                                                              2)  ………………………………………………….
                                                                              Phone……………………………………………
                                                                              3)  ………………………………………………….
                                                                              Phone……………………………………………
                       I (we) understand that the Terms and Conditions for a Credit Account which are included in the bottom of this
                       document. I (we) declare we are authorized to create a Credit Account on behalf of our company…
                       Signature          ………………………………………………….
                       Name               ………………………………………………….
                       Position           ………………………………………………….
                       Date               ………………………………………………….
                       When completed please return this form to our accounts team via the contact details listed on this document.
                       Once we have approved your account, how should we get back in touch with you?
                       Email              ………………………………………………….
                                          or
                       Phone              ………………………………………………….
                                                                                                Engineering Computer Services Ltd
                                                                                                              Cnr Te-Rapa & Ruffell Rd
                                                                                                                       Hamilton, 3200
                                                                                                                         New Zealand
                                                                                                                 Sales: 0800 849 2211
                                                                                                                      Tel: 07 849 2211
                                                                                                                     Fax: 07 849 2220
                                                                                                                       www.ecsnz.com
                      Your Key Contacts
                      To help us contact the right people in your company, you might want to list some of the key
                      contacts at your company. These could include engineers, purchasing people, accounts people
                      etc. Then when we are contacting you, we know the right people to get in touch with.
                      Name             …………………………………………………. Name                           ………………………………………………….
                      Role             ………………………………………………….  Role                          ………………………………………………….
                      Phone            ………………………………………………….  Phone                         ………………………………………………….
                      Mobile           ………………………………………………….  Mobile                        ………………………………………………….
                      Email            …………………………………………………. Email                          ………………………………………………….
                      *Feel free to add more contacts to this form, depending on your company structure
                      Our Contact Details
                                                                Within New Zealand                     Within Australia
               General Enquiries        Free Phone                 0800 849 2211                        1800 931 559
                                        Phone                     +64 7 849 2211                       +64 7 849 2211
                                        Fax                       +64 7 849 2220                       +64 7 849 2220
                                        Email                    sales@ecsnz.com                  sales@lappexpress.com.au
               Account Enquires         Phone                     +64 7 849 2211                       +64 7 849 2211
                                        Email                  accounts@ecsnz.com               accounts@lappexpress.com.au
                                                                                Engineering Computer Services Ltd
                                                                                             Cnr Te-Rapa & Ruffell Rd
                                                                                                    Hamilton, 3200
                                                                                                      New Zealand
                                                                                               Sales: 0800 849 2211
                                                                                                   Tel: 07 849 2211
                                                                                                  Fax: 07 849 2220
                                                                                                   www.ecsnz.com
                  Our Bank Account Details
                  We email all invoices to your accounts email address on a daily basis, and monthly we email you
                  with a complete statement with all your open invoices.
                  For payments from New Zealand bank accounts 
                          Payment to: Engineering Computer Services
                          ANZ Banking Group (New Zealand)
                          Swift Code:          ANZBNZ22
                          Account Number:      01 0311 0065864 00
                  For payments from Australian bank accounts in $AUD
                          Payment to: Engineering Computer Services
                          ANZ Banking Group (Australia)
                          Swift Code:          ANZBAU3M
                          Account Number:      01 3381 227663271