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RAY WHITE LIVESTOCK GLOUCESTER – NEW CLIENT REQUEST FORM All statements contained below are believed to be true as at the date signed by the signatory. This information remains current until  advised otherwise by the signatory.

SECTION 1: New Client Information

CLIENT NAME:

TRADING NAME:

ADDRESS:

POSTAL ADDRESS:

TELEPHONE/S:

EMAIL ADDRESS:

PIC NUMBER/S:

MSA NUMBER (If applicable)

ABN NUMBER:

ARE YOU REGISTERED FOR GST?

YES/NO If no, please fill out section 2 below  If yes, please fill out section 3 below

BANKING DETAILS:

Bank:__________Branch:_______  BSB:________________________  Account No.__________________

TRANSIT INSURANCE:

SECTION 2: Hobby Farmer Declaration (to be completed if not registered for GST)

If you have or will not be registering for an ABN will the supplies you make represent a supply that is private or  domestic in nature, or relates to a hobby? YES/NO

If an ABN is not included on invoices issued to other businesses, the business being supplied the goods or  services are required to withhold the top marginal tax rate plus the Medicare levy from payment, unless its  declared that the supply is private, domestic or hobby related.

I/We declare that my/our livestock dealings are those of a hobby farmer.

Signed (Registered client):____________________________ Date:________________

SECTION 3: GST Declaration (to be completed if registered for GST)

The registered client agrees to the following Terms & Conditions for the generation of Tax invoices, by Ray  White Livestock Gloucester on their behalf:

(a) Ray White Livestock Gloucester can issue tax invoices in respect of supplies where appropriate: (b) The registered client shall not issue tax invoices in respect of supplies that Ray White Livestock  Gloucester has generated on their behalf;

(c) The registered client acknowledges that they are registered for GST at the time of entering into this  agreement and that they will notify Ray White Livestock Gloucester if they cease to be registered.

Signed (Registered client)________________________________ Date:______________

72 Church Street, Gloucester NSW 2422 livestock.gloucester@raywhite.com 0265 589 077