New Supplier Details Form
To ensure timely payment, please prepare and attach a Bank Deposit Slip or Bank Statement to this form, and complete all the required details below:
Powerhouse contact
WHO SENT YOU THIS FORM?
supplier details
COMPANY / supplier name
CONTACT PERSON
STREET ADDRESS
POSTAL ADDRESS
CONTACT EMAIL
CONTACT PHONE
FAX
IF APPLICABLE
OUTLINE OF THE SERVICES/GOODS PROVIDED:
ARE YOU AN AUSTRALIAN-BASED BUSINESS / SUPPLIER?
YES
NO
International Provider
ABN
DOES YOUR BUSINESS/ORGANISATION HAVE A REGISTERED ABN?
YES
NO
PLEASE COMPLETE THIS
Statement by Supplier form
PLEASE PROVIDE THE ABN NUMBER
AUSTRALIAN REGISTERED BUSINESSES ONLY
Are you Registered on the
buy NSW Supplier Hub
?
YES
NO – we encourage registering via hyperlink above
BANKING INFORMATION
BANK NAME
BANK ADDRESS
ACCOUNT NAME
ACCOUNT NUMBER/IBAN/NATIONAL CLEARING CODE
BIC / SWIFT CODE
BANK STATEMENT OR BANK DEPOSIT SLIP
ENSURE THAT ACCOUNT NAME, NUMBER
AND BIC/SWIFT CODE ARE VISIBLE COVER THE BANK
TRANSACTIONS FOR PRIVACY
PLEASE NOTE
As a State Government agency our payment terms are Thirty (30) days from date of invoice for small business. End of the month following the invoice date for all other businesses.
National Provider
Are you a registered Indigenous business/supplier?
YES
NO
If yes, which of the following data base are you registered?
Supply Nation
Indigenous Chamber of Commerce
Office of the Registrar of Indigenous Corporations
None of the above
ABN
DOES YOUR BUSINESS/ORGANISATION HAVE A REGISTERED ABN?
YES
NO
PLEASE COMPLETE THIS
Statement by Supplier form
PLEASE PROVIDE THE ABN NUMBER
AUSTRALIAN REGISTERED BUSINESSES ONLY
Are you Registered on the
buy NSW Supplier Hub
?
YES
NO – we encourage registering via hyperlink above
BANKING INFORMATION
BANK NAME
ACCOUNT NAME
ACCOUNT NUMBER
BSB
BANK STATEMENT OR BANK DEPOSIT SLIP
ENSURE THAT ACCOUNT NAME, NUMBER
AND BSB ARE VISIBLE COVER THE BANK
TRANSACTIONS FOR PRIVACY
PLEASE NOTE
As a State Government agency our payment terms are Thirty (30) days from date of invoice for small business. End of the month following the invoice date for all other businesses.
Privacy Policy