FA01 - New Creditor Form Full Name of Trading Entity*This field is required. * Required Field. ABN: Tick this box if you do not have an ABN Number Tick here If you do not have an ABN number, please upload a completed Statement by a supplier not quoting an ABN form Registered for GST? YesNo Business Address*This field is required. * Required Field. Suburb*This field is required. * Required Field. State*This field is required. Select an Option WA ACT NT NSW QLD SA TAS VIC * Required Field. Post Code*This field is required. * Required Field. Telephone Number*This field is required. * Required Field. Alternate Telephone Number Contact Name Purchase Order Email*This field is required. * Required Field.* Please enter a valid email address. Types of goods or services provided*This field is required. Select an Option Accomodation and food services Administrative and support services Agricultural, forestry and fishing Arts and recreation services Construction Education and training Electricity, gas, water and waste services Financial and insurance services Information media and telecommunications Manufacturing Mining Professional, scientific and technical services Public administration and safety Rental, hiring and real estate services Retail trade Transport, postal and warehousing Wholesale Trade Other service * Required Field. If selected other, please specify Are you an independent contractor as per ATO guidelines YesNo Refer to the ATO Decision tool to see if you are unsure if you are an independent contractor If you selected yes above, please answer the following questions: Are you being paid to perform services related to the making of a film, tape, disc, television or radio broadcast? YesNo Are you a sportsperson, artist or entertainer paid to perform, present or participate in any music, play, dance, entertainment, sport, display or promotional activity, or similar activity? YesNo Are you a worker under a contract that is wholly or principally for their labour? YesNo Are you a worker who performs work that is wholly or principally of a domestic nature for more than 30 hours per No week? YesNo To facilitate payment to your super, we will also require your date of birth. Please provide it below: If you answered Yes to any of the above questions, you are eligible to be paid superannuation guarantee. Please fill in the Superannuation Standard Choice Form and submit it with this form. Have you attached your completed Super Form? Failure to supply the required details may result in payment delay. Bank Details Bank*This field is required. * Required Field. Branch Bank Account Name*This field is required. * Required Field. BSB*This field is required. * Required Field. Account Number*This field is required. * Required Field. Remittance Advice Contact Accounts Receivable Phone Number Remittance Email Address*This field is required. * Required Field.* Please enter a valid email address. Cheque Payment Required (Note: Default Payment method is EFT, tick the box if you require Cheque Payments) YesNo Tick below I confirm that the above bank details are correct Which City staff member has directed you to complete this form?*This field is required. * Required Field. Insurance Upload Group 4 Please upload up to date insurance certificates relevant to the activities or services performed. Failure to do so may impact your creditor/supplier status. Insurance Certificates Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx To improve our internal control processes at the City with respect to supplier payments we have engaged EFTsure (https://www.Eftsure.com.au) to provide payment verification services. EFTsure provides a service to ensure that payments are made to the intended recipients because banks ignore account names when processing payments. You will receive an email request to verify your details. Please can you action this promptly. I have agreed to submit this application by electronic means. I can confirm that the information given in this application is true, complete and accurate. By checking this box and typing my name below, I am electronically signing my application. Please tick here Position*This field is required. * Required Field. First and Last Name*This field is required. * Required Field. The City of Greater Geraldton collects the personal information you provide in relation to the Application for Approval to New Creditor Form so we can deliver the service, process your request, and meet our legal obligations under the Local Government Act 1995 and any other related legislation. Your information may be shared with government agencies, contractors, or others where authorised by law or with your consent. Where required by law, your personal information will be made publicly available, e.g. public registers. The City manages personal information in accordance with relevant privacy legislation and takes reasonable steps to protect it from unauthorised access or disclosure. You may request access to, or correction of, your personal information by contacting the City at privacy@cgg.wa.gov.au. Type the code from the image: The code you entered is not valid. Get Audio CodeType the code from the image Was this page helpful? How can we improve this page? Email Address*This field is required. * Required Field.* Please enter a valid Email Address Type the code from the image: Do not fill this textbox.