B2B Registration Form

Apply for a wholesale account with Lil'Kooee

1. Business Details

Legal Business Name

Trading Name (if different)

ABN / Tax Registration Number

Business Structure

Years in Operation

Business Website or Social Media

Type of Business

Full Name

Role / Position

Phone Number

Shipping Company Name

Street Address

City

State / Region

Postcode

Accounts Payable Contact Name

Accounts Payable Email

Accounts Payable Phone

I agree to Lil'Kooee's Wholesale Terms & Conditions.

I agree to the 30-Day Payment Term and understand all accounts are monitored by Active Debit Recovery Pty Ltd.

I declare all information provided is true and correct.

Authorised Person Full Name

Position

Date