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Corporate and Commercial Services Department

TF001 TRIM Reference:

NEW CREDITOR FORM Please complete the details below and return this form to the City of Greater Geraldton Accounts Payable at your earliest possible convenience. Company Name: Mailing Address: ABN: Phone Number:

Fax Number:

Mobile Number:

Contact:

Enquires Email: Bank and Branch: Branch BSB Number: Account Number: Account Name: Accounts Receivable Contact: Accounts Receivable Phone Number: If you would like to receive your remittance advices and/or purchase orders via email, please complete the following section. Remittance Email Address: Purchase Order Email Address: Authorised Officers Name: Authorised Officers Title: Contact Telephone Number:

Authorised Officer Signature

Date

Email completed applications to accounts@cgg.wa.gov.au


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