First Name *

Last Name *

Company Name *

New Zealand Business Number (NZBN) 

Street Address *

Address Line 2 

Country *

New Zealand

Suburb / City *

Postcode *

Phone Number *

I have disclosed any and all relevant information that may affect this application for credit.

Everything that I have stated above is true and accurate.

I give consent to Bambu to:

• Make enquiries with relevant third parties and / or credit agencies regarding credit history
• Release information for the above purpose to the extent necessary, to relevant third parties and / or credit agencies
• Instruct an agent to carry out any credit enquiries, and the individual agrees to the above authorisations which will apply to such agent.

I agree and consent to the Terms and Conditions of Sale

Electronic Signature *