Domestic LPG Account Application Form

First Name *		This field is required.		Last Name *		This field is required.
First Name				Last Name

Postal Address *

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Suburb *

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Postcode *

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Leave blank if same as above:
Delivery Address

Suburb

Postcode

Phone *

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Work

Fax

Mobile (1) *

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(2)

Email Address *

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Driver's License / ID *

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ABN

Renting *

Yes No This field is required.

If yes, Property Agent

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Emergency Contact Personal Applicants (provide relative not living at the same address)
First Name		This field is required.		Last Name		This field is required.

Address

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Phone

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GENERAL CONDITIONS OF SUPPLY

The applicant agrees to trade on a cash on delivery basis for the first six months from the below date and then subject to meeting the requirements of Murray Sales Pty Ltd may apply for a 30 day credit account.
The risk in all Goods which are sold by Murray Sales to a Customer will pass to the Customer upon delivery by Murray Sales to the Customer.
Any and all expenses, costs or disbursements incurred by Murray Sales in recovering any outstanding monies including Debt Collection Agency fees, Solicitor costs and Civil Court fees shall be paid in full by the applicant.
Despite the passing of risk, the legal ownership of all Goods sold by Murray Sales to the Customer will not pass to the Customer and will remain with Murray Sales until payment in full of the Price and all Additional Charges relating to the Goods and amounts outstanding in the Customer’s account with Murray Sales. In the case of payment by cheque or credit card, payment will not be treated as having been made until the cheque or credit card transaction has cleared.
The Customer will be responsible for the safe custody and good condition (fair wear and tear excepted) of all Cylinders from the time of their delivery until their safe return to Murray Sales; not sell, encumber or part with possession of control of or allow any lien to be created on the Cylinders and will protect the Cylinders against distress, execution or seizure. The Customer will not (except with the written approval of Murray Sales) refill or allow the refilling of any Cylinders or let them be used otherwise for storage, transport or use of Gas filled into them by or on behalf of Murray Sales.
Murray Sales may give written notice to the Customer that it requires all the Cylinders held by the Customer to be returned forthwith to Murray Sales. If the Customer does not return the Cylinders within (7) days of receipt of such notice, Murray Sales may enter upon the Customer’s Premises where the Cylinders are thought to be and retake possession of and retain them (together with any Gas remaining in them, in respect of which Murray Sales will not be obliged to give any credit to the Customer).

Is this gas supply for a new uncommissioned LPG installation? *

Yes No This field is required.

If yes, COC Number

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The Applicant acknowledges to have read and agrees that all purchases of goods and services will be subject to Murray Sales’ Conditions of Supply as above.

You must agree to the terms & conditions to apply for an account.

Signed (Name)

You must sign your name to submit this form.