Please fill all required fields
      Absolute Organix new customer application
    Tel: (011) 614 5822
    Please note this is not a credit application  
    Customer Name/Name of Business 
    VAT No 
    Select business type 
    Postal address 
    Postal code 
    Delivery Address 
    Postal code 
    Office telephone 
    Mobile No 
    email address 
    Fax No 
    Website address 
    Name of person responsible for payment 
    ID Number 
    Trade Reference 1 
    Telephone No 
    Trade Reference 2 
    Telephone No 
    By submitting this form you expressly agree to the following:
    1. Claims for shortages, damages or incorrect deliveries will not be considered unless reported within 24 hours of delivery.
    2. A customer may not return goods to Absolute Organix without prior written consent.
    3. All goods and services shall be paid for, in full, prior to delivery.
    4. Where terms are agreed upon in writing, payment will made strictly according to such terms.
    5. Ownership of goods shall only pass once all amounts due in respect thereof have been paid for in full.
    6. In the event of non-payment by the customer and legal action needs to be taken by Absolute Organix, these costs will be for the customer's account.
    7. The jurisdiction of the South Gauteng High Court will apply in any legal matter arising between the parties.
    Name of person submitting this form
    Powered By SpreadsheetConverter (6.0.4287.4287)