Creditor Application

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Creditor Application ID

Complete this form if you need to be set up as a supplier to receive payments from Council.

Credit payments will be made directly into your nominated bank account. This application is to be completed by all creditors.

Creditor Name*

Postal Address*

Street Address City State Postcode Country

ABN

Registered for GST

Yes

Phone*

Email*

Contact Name*

First Last

Contact Position*

Email for remittance*

Name of the council staff member you've been in contact with*

Submission Date

Bank Details

Note: You will be contacted by EFTSURE to verify your bank details by phone or email. Please ensure you respond when contacted as we are unable to deposit funds to your account until this process has been completed.

BSB*

Account Number*

Account Name*