Direct Debit & Credit Application Form

Ready to join us as a wholesale buyer? Fill out this straightforward form to start your journey with North Harbour Fish Market, where fresh quality meets convenience.

Trade name

Legal entity name (the customer)

Postal address

Deliver address:

Orders contact name

First

Last

Orders phone

Orders email address

Accounts contact name

Accounts email address:

Type of business

Nature of business

Anicipated monthly trade

Time in business

Bank and branch

Trade reference (First)

Please enter Name, Address & Phone

Trade reference (Second)

Please enter Name, Address & Phone

Trade reference (Third)

Please enter Name, Address & Phone

Directors / Owners

Please enter Name, Address & Phone

Name of your account to be debited (acceptor)

Name of your bank

Bank Code

Branch Code

Account Number

Suffix

From the acceptor to

Insert name of acceptor’s bank (your bank)

Declaration

I have read the terms and conditions of sale set out in this document and agree that those conditions will apply to all contracts between North Harbour Fish Market Limited and the Customer.
I warrant to North Harbour Fish Market Limited that I am authorised to enter into this agreement on the Customer’s behalf.
I warrant to North Harbour Fish Market Limited that the information given in this application is to the best of my knowledge correct.
I am agree with Terms & conditions of sale.
I authorise you to debit my account with the amounts of direct debits from North Harbour Fish Market Ltd with the authorisation code specified on this authority in accordance with this authority until further notice.

MAIL US

info@nhfm.co.nz

Fresh and Fair Seafood in New Zealand.

HEAD OFFICE

12 Vega Place
+022 133 7590