Creditor Intake Form Please complete the form below - a copy will be emailed to you: 1General Details2Account Details 3Account Details cont.4Compliance Items5Additional Information6Declaration and Authorisation General DetailsBusiness Name(Required)Contact Person(Required) First Last Position(Required)Postal Address(Required) Postal Address line 1 Postal Address line 2 City/Suburb State Post Code Primary phone number(Required)Alternate phone number (if different to primary number)Email address for Quote Requests / Work Orders(Required) Email address for Payment Remittances Leave blank if same as aboveWebsitePrimary Business Type(Required)-- Please Choose --Accountant / AuditorAir-conditioningArchitectAsbestos RemovalAsphalt / DrivewaysBricklayerBuilderBuilding Consultant / Engineers / SurveyorsCaretaker / Building ManagerCarpenterCarpet CleaningCleanerConcreterDemolition ContractorDoors & WindowsElectricianFencing & GatesFire Protection / Essential ServicesGarage Doors & Auto GatesGarbage, Waste & RecyclingGlazierGraffiti RemovalGutter Repairs / Gutter CleaningHandymanHygiene & Sanitary ServicesInsurance BrokerInsurance ValuerIrrigation SystemsLawn Mowing & LandscapingLift MaintenanceLine MarkingLocksmithMaintenance ServicesMeeting Room HireMould RemovalPainterPest ControlPlastererPlumberPumps & SumpsRendererRestorationRoofing, Awnings & BlindsScaffoldingSecurity Systems & PatrolsSignwriter / MakerSkylightsSolar InstallationSupplier – AppliancesSupplier – Carpet/FlooringSupplier – Garden EquipmentSupplier – Gas BottlesSupplier – Gym EquipmentSupplier – Hardware / Aluminium / FabricationSupplier – Lighting/ElectricalSupplier – Plant HireSwimming Pool / Spa MaintenanceTelecommunicationsTiler - Roof, Wall & FloorTree Surgeon / Arborist / Lopper / Land ClearingTV Antenna Repair / InstallationWater ProofingWater ServicesWindows & DoorsOtherOther Business Type(Required)Please provide details Account DetailsPreferred Payment Method(Required) EFT Direct Entry BPay BSB Number(Required)Account Number(Required)Biller Code(Required) Account Details cont.Email Remittances(Required) Yes No Legal Entity(Required)Name associated with Australian Business Number (ABN)Australian Business Number (ABN)(Required)GST Registered?(Required) Yes No Compliance Items It is a legislative requirement that all contractors hold the appropriate compliance items for their industry. If our office does not hold copies of the current compliance items relevant for your company our team of Strata Managers will not be able to send you work or issue payment of tax invoices received.Public Liability(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.Please provide a Certificate of CurrencyProfessional Indemnity(Required) Certificate of Currency provided Not held N/A for my business type Exempt Please provide a Certificate of Currency(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.Please provide a Certificate of CurrencyWorkers Compensation(Required) Certificate of Currency provided Not held N/A for my business type Exempt Please provide a Workers Compensation Certificate of Currency(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.Please provide a Certificate of CurrencyPersonal Injury & Illness(Required) Certificate of Currency provided Not held N/A for my business type Exempt Please provide a Personal Injury & Illness Certificate of Currency(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.Please provide a Certificate of CurrencyBuilding Practitioners Registration(Required) Certificate of Currency provided Not held N/A for my business type Exempt Please provide a Building Practitioners Registration Certificate of Currency(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.Please provide a Certificate of CurrencyNSW Contractor & Tradesperson License(Required) Copy of licence provided Not held N/A for my business type Exempt Please provide a copy of your NSW Contractor & Tradesperson License(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.NSW Master License(Required) Copy of licence provided Not held N/A for my business type Exempt Please provide a copy of your NSW Master License(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.NSW Pesticide License(Required) Copy of licence provided Not held N/A for my business type Exempt Please provide a copy of your NSW Pesticide License(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.NSW Real Estate License(Required) Copy of licence provided Not held N/A for my business type Exempt Please provide a copy of your NSW Real Estate License(Required)Accepted file types: doc, docx, pdf, jpg, jpeg, png, Max. file size: 8 MB.If you chose Exempt for any of the above Compliance items, please provide a reason:(Required) Additional InformationDo you have a you have a Capability Statement or any other promotional documents on the services your company provides? Yes No Please provide copies here(Required) Drop files here or Select files Accepted file types: doc, docx, pdf, png, jpg, Max. file size: 8 MB. Declaration and Authorisation I/we declare that to the best of my knowledge and belief, the information provided on this contractor intake form and in any attached documentation is true and correct and that I/we have not withheld any relevant information. I/we consent to Lake Group Strata using the personal information I/we have provided for the purpose of establishing me/my/our company in their contractor database and/or maintaining a current record of all relevant compliance items in accordance with the legislation. I/we understand that if I/we choose not to provide the required details, this is my/our choice; however, Lake Group Strata will not be able to send me/my/our company work or issue payment of any tax invoices for work completed. I/we acknowledge that if I/we do not agree to the collection of this personal information then Lake Group Strata will be unable to establish me/my/our company in their contractor database, issue quote requests and work orders or issue payment of any tax invoices for work completed.Please confirm - Declaration and Authorisation(Required) I/we Agree I /we Disagree Name of person completing this form(Required) First Last PhoneThis field is for validation purposes and should be left unchanged.
