ContractCustomer Agreement • November 15th, 2021
Contract Type FiledNovember 15th, 2021CUSTOMER Limited Liability Company Partnership Sole Trader Other Legal Name Company Number if a company / Date of Birth if an individual Postal Address Email Telephone Contact Person Name and Address of Directors / Partners / Proprietors / Shareholders Name Designation Residential Address and Telephone Number Date of Birth GOODS AND SERVICES TO BE SUPPLIED CREDIT REFERENCES Name, address and telephone numbers (minimum of 2 regular established accounts) 1. 2. DECLARATION AND AGREEMENTIn consideration of Mirage agreeing to provide goods and services to the Customer named above, then, on behalf of the Customer, you:1. In accordance with the Privacy Act 1993, consents to Mirage contacting the above credit references to discuss the Customer’s credit record2. Agree to Mirage’s Terms and Conditions (which can be found at www.miragevisual.com); and3. Declare that the information supplied in this form is correct.Full Name SignedDesignation Date GUARANTEEIn consideratio