NZRA Z CARD - Account Application Form - Retail NZ

Download PDF
1 downloads 110 Views 599KB Size Report
Comment
Phone 04 805 0830 Fax 04 805 0831 Email [email protected] .... domain white list. ... You must notify the NZRA of any
NZRA Z CARD NZRA Z CARD Account Account Application Form Application Form 1. PERSONAL / BUSINESS DETAILS 1. PERSONAL / BUSINESS DETAILS

Company (Legal) Company (Legal) Name: Name: Trading Name: Trading Name: Postal Address: Postal Address:

Postcode: Postcode: Title: Title:

Contact Name: Contact Name: Telephone: ( ) Fax: ( ) Telephone: ( ) Fax: ( ) Email: Mob: ( Email: Mob: ( Membership New Zealand Business Tourism Industry Membership New Zealand Business Tourism Industry & Number: Retailers Association New Zealand Association NZ & Number: Retailers Association New Zealand Association NZ Business Company Sole Trader Partnership Other: Business Company Sole Trader Partnership Other: Structure: Structure: Incorporation / Company Number: Incorporation / Company Number:

) ) Membership number Membership number

2. PERSONAL GUARANTEE & DETAILS

PERSONAL & DETAILS Full2. names, residentialGUARANTEE address, title of each partner/director/shareholder/trustee, etc. plus nature of interest In consideration of the Newaddress, Zealand Retailers Association Incorporated (hereinafter referred to as the NZRA) supplying and at my request agreeing to Full names, residential title of each partner/director/shareholder/trustee, etc. plus nature of interest continue to supply and other goods and service and to make advances to the business/company/trust/partnership/incorporation In consideration of materials the New Zealand Retailers Association Incorporated (hereinafter referred to as the NZRA) supplying and at my request agreeing to (hereinafter referred to as "the debtor"): continue to supply materials andprincipal other goods and service and to make advances to the business/company/trust/partnership/incorporation (hereinafter referred to as "the principal debtor"):

1. 1.

I I

Full name of Guarantor Full name of Guarantor

Title (e.g. Director, Manager) Title (e.g. Director, Manager)

of of Residential Address Signed Residential Address Signed 2. 2. I I Full name of Guarantor Title (e.g. Director, Manager) Full name of Guarantor Title (e.g. Director, Manager) of of Residential Address Signed Residential Address (For additional partners/directors/shareholders/trustees, pleaseSigned attach a separate sheet) (For additional partners/directors/shareholders/trustees, please attach a separate sheet) do hereby guarantee to the NZRA the due and punctual payment therefore and the payment of all monies and obligations now

Date Date

Date Date

due to become due by the principal debtor answerable and liable to you therefore following provisions shall be applicable this do hereby guarantee toand the agree NZRA to thebedue and punctual payment therefore andand the the payment of all monies and obligations nowto due toguarantee. become due Thethe guarantee a continuing agreement. No granting credit of former credit or granting of time to the principal debtor no waiver by principalisdebtor and agree to be answerable andofliable toextension you therefore and the following provisions shall be applicable to thisand guarantee. indulgence or neglect to sue onagreement. the NZRA'sNo part nor theofrelease of any securities held by the NZRA norofthe winding or bankruptcy of the The guarantee is a continuing granting credit extension of former credit or granting time to theup principal debtor and no waiver principal debtor shall effect to you hereunder and as of between the NZRA and shall be to be up a principal debtorofand indulgence or neglect to suemy on liability the NZRA's part nor the release any securities held byme theI NZRA nordeemed the winding or bankruptcy theshall be liable to the NZRA accordingly. guarantee shall continue notwithstanding that principal debtor's with you mayand from timebe principal debtor shall effect my This liability to you hereunder and in as force between the NZRA and methe I shall be deemed to account be a principal debtor shall to time credit.accordingly. Within seven (7)guarantee days fromshall my receipt ofinnotice writing of any default the partdebtor's of the principal maketime payment liable tobe theinNZRA This continue force in notwithstanding that theon principal account debtor, with youI shall may from to the all sums in respect of which suchmy default hasofbeen made. timeNZRA be in of credit. Within seven (7) days from receipt notice in writing of any default on the part of the principal debtor, I shall make payment to the NZRA of all sums in respect of which such default has been made.

3. HOW WOULD YOU LIKE YOUR INVOICE? 3. HOW WOULD YOU LIKE YOUR INVOICE? Please post my invoice. I acknowledge that the card fee will be $1 per card per month. Please post my invoice. I acknowledge that the card fee will be $1 per card per month. Please email my invoice. I acknowledge that the card fee will be only 50 cents per card per month. Please email my invoice. I acknowledge that the card fee will be only 50 cents per card per month.

4. AFFIRMATION OF DETAILS 4. AFFIRMATION OF DETAILS I/We confirm that all foregoing statements are true and complete. I/We understand that the NZRA reserves the I/We confirm that foregoing statements are true I/We understand that the NZRA the right to decline anyallapplication. Upon acceptance of and this complete. application, I/We agree to be bound by thereserves Terms and right to decline any Upon of thispages. application, I/We agree to be bound by the Terms and Conditions of use forapplication. Z Card as set outacceptance on the following Conditions of use for Z Card as set out on the following pages.

March 2012

Full name Full name

Signed Signed

Date Date

AFTER COMPLETION, PLEASE RETURN ALL FORMS BY POST TO: AFTER COMPLETION, PLEASE RETURN ALL FORMS BY POST TO: New Zealand Retailers Association Incorporated, PO Box 12 086, Wellington 6144 New Zealand Retailers Association Incorporated, PO Box 12 086, Wellington 6144 Questions? Phone 04 805 0830 Fax 04 805 0831 Email [email protected] Questions? Phone 04 805 0830 Fax 04 805 0831 Email [email protected]

2012 PageMarch 1 of 3 Page 1 of 3

5. TERMS TERMS AND AND CONDITIONS CONDITIONS 5. Definitions&&Acceptance AcceptanceofofConditions Conditions 1.1.Definitions 1.1“Cardholder” “Cardholder”- -means meansthe theperson personpresenting presentingthe theZZCard Cardwhich whichhas hasbeen beenissued issuedatatyour yourrequest requeston onyour yourZZCard Cardaccount. account. 1.1 “You&&Your” Your”- -means meansthe thepartnership, partnership,sole soletrader, trader,trust, trust,group groupor orcompany companyatatwhose whoserequest requestNZRA NZRAagrees agreesto tomake makeaaZZCard CardAccount Accountfacility facilityavailable. available. “You "NZRA"- -means meansthe theNew NewZealand ZealandRetailers RetailersAssociation AssociationIncorporated, Incorporated,its itssuccessors successorsand andassigns. assigns. "NZRA" "ZEnergy" Energy"- -means meansZZEnergy EnergyLimited, Limited,its itssuccessors successorsand andassigns. assigns. "Z “ZCard” Card”- -means meansaacard cardso sonamed namedand andissued issuedby byZZEnergy Energywhich whichisisto tobe beused usedfor forthe thepurposes purposesdescribed describedby bythe theNZRA’s NZRA’sconditions conditionsofofuse use “Z “Termsand andConditions ConditionsofofUse” Use”- -means meansthese theseconditions conditionsofofuse useand andany anynotified notifiedamendment amendmentor orconditions conditionsofofuse useininaddition additionto tothese theseconditions. conditions. “Terms "Month”- -aareference referenceto toaamonth monthisisaacalendar calendarmonth. month. "Month” “Salesvoucher” voucher”- -means meansthe theZZCard Cardvoucher voucheron onwhich whichsales salestransactions transactionsare arerecorded recordedatatthe thetime timeofofthe thetransaction. transaction. “Sales 1.2ZZCard Cardisisbrought broughtto toyou youby byNZRA NZRAand andZZEnergy. Energy.Each EachZZCard Cardisisissued issuedto toaaCardholder Cardholderatatthe therequest requestofofyou, you,the theAssociation Associationmember. member.Cardholders Cardholders 1.2 areauthorised authorisedby byand andact actas asagents agentsfor foryou youand andthe thefirst firstuse useofofthe theZZCard Cardconfirms confirmsacceptance acceptanceofofthe theconditions conditionsset setout outbelow. below. are Card 2.2.ZZCard EachZZCard Cardisisidentified identifiedwith: with: Each uniqueCard Cardnumber number ••AAunique TheCardholder's Cardholder'sname nameor or‘Any ‘AnyDriver’ Driver’(You (Youmay mayelect electto touse useyour yourbusiness businessname nameininplace placeofof`Any `AnyDriver') Driver') ••The TheZZCard CardAssociation Associationnumber numberand andname name ••The Thevehicle’s vehicle’sdescription descriptionor or‘Any ‘AnyVehicle’ Vehicle’respectively respectively ••The Thevehicle’s vehicle’sregistration registrationnumber numberififapplicable applicable ••The YourZZCard Cardcustomer customeraccount accountnumber numberand and ••Your Thecard cardexpiry expirydate date ••The Youare areresponsible responsiblefor forensuring ensuringthat thatcardholders cardholdersare areaware awareof, of,and andcomply complywith, with,the theManagement ManagementControls Controlsand andPurchase PurchaseLimits. Limits.ZZCard Cardisisfor foruse useinin You NewZealand Zealandonly. only.ZZCard Cardremains remainsthe theproperty propertyofofZZEnergy Energyatatall alltimes timesand andmust mustbe besurrendered surrenderedupon uponrequest. request.Neither NeitherNZRA NZRAnor norZZEnergy Energyaccepts acceptsany any New responsibilityfor forunauthorised unauthoriseduse useand andconsequences. consequences. responsibility PersonalIdentification IdentificationNumber Number(PIN) (PIN) 3.3.Personal PINwill willbe beissued issuedwith witheach eachcard cardififyou youso sorequest requeston onthe theCard CardOrder OrderForm. Form.Use Useofofthe thePIN PINby bythe theCardholder Cardholderisismandatory mandatoryatatZZEnergy Energytruck truckstops stops AAPIN and,where wherecustomers customershave haverequested requestedcompulsory compulsoryPIN PINentry, entry,atatall allZZEnergy Energysites. sites.Where Whereuse useofofthe thePIN PINisisoptional, optional,the thecard cardmay maybe beused usedatatZZEnergy Energy and, servicestations stationsand andCardholders Cardholdersmay maysign signtheir theirnames nameson onthe thespace spaceprovided providedon onthe thesales salesvoucher. voucher.The ThePIN PINmailer mailershould shouldbe bedestroyed destroyedby byshredding shreddingor or service otherdestructive destructivedisposal. disposal.IfIfthe thePIN PINisisrequired requiredto tobe begiven givento toseveral severaldrivers, drivers,you youare areresponsible responsiblefor forensuring ensuringthe thePIN PINisiscommunicated communicatedand andrecorded recorded other securefashion. fashion.You Youmay maychoose chooseyour yourown ownPINs PINsatatthe thetime timeyou youorder orderyour yourcards. cards.DO DONOT NOTchoose chooseaanumber numberthat thatyou youuse useelsewhere elsewhere(e.g. (e.g.credit credit ininaasecure card/eftposcard cardPIN, PIN,security securitysystem systemcode, code,etc.). etc.). card/eftpos Property 4.4.Property TheZZCard Cardremains remainsthe theproperty propertyofofZZEnergy Energyand andmust mustbe bereturned returnedto toNZRA NZRAwhen whenrequested requestedby byNZRA NZRAor orZZEnergy. Energy. The Suspensionand andCancellation Cancellation 5.5.Suspension NZRAreserves reservesthe theright rightto tosuspend suspendor orcancel cancelaaZZCard Cardor orAccount Accountatatany anytime timewithout withoutnotice. notice.You Youmay maycancel cancelaaZZCard Cardor orAccount Accountatatany anytime timeby by NZRA forwardingnotice noticeininwriting writingto toNZRA NZRAquoting quotingyour yourZZCard Cardcustomer customeraccount accountnumber numberand andthe thecard cardnumbers numbersofofthe thecards cardsyou youwish wishto tocancel. cancel.IfIfyou youclose close forwarding yourZZCard Cardaccount, account,any anymoney moneyowing owingto toNZRA NZRAwill willbe bepayable payablewithin within77(seven) (seven)days daysofofthe thedate dateofofthe thefinal finalinvoice invoiceor orstatement. statement. your Securityand andLoss LossofofZZCard Card 6.6.Security Youare areresponsible responsiblefor forthe thesafe safecustody custodyand andauthorised authoriseduse useofofeach eachZZCard Cardand andPIN. PIN.Loss, Loss,theft theftor orunauthorised unauthoriseduse useofofany anyZZCard Cardmust mustbe benotified notifiedto to You NZRA.Written Writtennotice noticemust mustalso alsobe begiven givento toNZRA NZRAatatP0 P0Box Box12086, 12086,Wellington, Wellington,phone phone(04) (04)805 8050830, 0830,fax fax(04) (04)805 8050831 0831or oremail [email protected]. [email protected]. NZRA. Adviceshould shouldinclude includethe thecard cardnumber numbershown shownon onthe thecard(s). card(s).Liability Liabilityremains remainswith withyou youuntil untilnotice noticeisisacknowledged acknowledgedby byNZRA. NZRA.ZZCards Cardswhich whichhave have Advice expiredshould shouldbe bedisposed disposedofofafter aftercutting cuttingthem themininhalf. half. expired ManagementControls Controls 7.7.Management 7.1(a)Category CategoryRestrictions Restrictions- -The TheCardholder Cardholdermay maypurchase purchaseZZEnergy Energybranded brandedmotor motorfuels, fuels,lubricants lubricantsand andgoods goodsand andservices servicesininthe thecategories categoriesspecified specified 7.1(a) byyou youininthe theCard CardOrder OrderForm Formand andindicated indicatedby bythe theapplicable applicableicons iconson onthe thecard. card. by 7.1(b)Spending SpendingLimits Limits- -You Youcan canset setdaily dailyand andmonthly monthlydollar dollaramount amountspending spendinglimits limitsfor foreach eachZZCard. Card.Please Pleasenote: note:the thecard cardlimit limitisischecked checkedprior priorto tothe the 7.1(b) transactionproceeding. proceeding.IfIfthe thelimit limithas hasnot notpreviously previouslybeen beenreached, reached,then thenthe thecurrent currenttransaction transactionwill willbe beallowed, allowed,even evenififthat thattakes takesthe thecard cardover overits its transaction limit.(You (Youmay mayinstruct instructus usto toalter alterspending spendinglimits limitson onexisting existingcards. cards.Note Notethat thatspending spendinglimits limitsmay maybe bevaried variedby byZZEnergy Energyfrom fromtime timeto totime timeininresponse response limit. tofluctuations fluctuationsininfuel fuelprices.) prices.) to 7.1(c)Odometer Odometer- -You Youcan canrequire requirecompulsory compulsoryodometer odometerentry entryatattime timeofofpurchase. purchase.This Thisoption optionisisselected selectedon onthe theCard CardOrder OrderForm. Form. 7.1(c) 7.1(d)Compulsory CompulsoryPIN PIN- -you youcan canenhance enhancethe thesecurity securityofofaaZZCard Cardby byrequesting requestingCompulsory CompulsoryPIN PINon onthe theCard CardOrder OrderForm. Form. 7.1(d) 7.2You Youcan canset setcompletely completelydifferent differentManagement ManagementControls Controlsfor foreach eachcard cardyou youorder, order,so soplease pleasecomplete completeone oneCard CardOrder OrderForm Formfor foreach eachcard cardyou you 7.2 require,to toavoid avoidconfusion. confusion.You Youare areresponsible responsiblefor forensuring ensuringthat thatthe theCardholder Cardholderisisaware awareof, of,and andcomplies complieswith, with,the theManagement ManagementControls. Controls. require, Authorityto toNZRA NZRA 8.8.Authority TheNZRA NZRAisisauthorised authorisedto todebit debityour yourZZCard Cardaccount accountwith withthe thetransactions transactionsprocessed processedon onyour yourZZCards. Cards. The

Continuedon onnext nextpage... page... Continued March2012 2012 March

Continuedon onnext nextpage page--Page Page22of of33 Continued

5. TERMS AND CONDITIONS (CONTINUED)

5. TERMS AND CONDITIONS (CONTINUED) 9. Effecting a Purchase 9.1 Truck Stop. Before obtaining fuel, the Cardholder inserts the Z Card into the machine. Easy-to-follow instructions tell the Cardholder exactly what to do. 9. Effecting a Purchase After takingStop. delivery of the fuel, the Cardholder returns to collect Z Card salesmachine. voucher.Easy-to-follow The transaction will only proceed with the use of thewhat PIN. to do. 9.1 Truck Before obtaining fuel, the Cardholder inserts the Zthe Card into the instructions tell the Cardholder exactly 9.2 Service Station. When a Zfuel, Cardthe is presented the Z Energy Service employee forThe payment, the Cardholder will bewith giventhe a Zuse Card salesPIN. voucher. After taking delivery of the Cardholdertoreturns to collect the ZStation Card sales voucher. transaction will only proceed of the Alternatively (and subject the Cardholder pay-at-pump withemployee the use offor thepayment, PIN. The the Cardholder must the asales voucher once the 9.2 Service Station. Whentoa availability) Z Card is presented to the Z may Energy Service Station Cardholder willcollect be given Z Card sales voucher. transaction is complete. Alternatively (and subject to availability) the Cardholder may pay-at-pump with the use of the PIN. The Cardholder must collect the sales voucher once the 9.3 The voucher records, amongst other details: card number, pump price value of fuel purchased, details of other items purchased, the time and date of transaction is complete. purchase, the name of theamongst Z Energyother site, the quantity fuel purchased andvalue (if required) the odometer reading. Theitems salespurchased, voucher will betime the and onlydate receipt 9.3 The voucher records, details: card of number, pump price of fuel purchased, details of other the of issued to the Cardholder. purchase, the name of the Z Energy site, the quantity of fuel purchased and (if required) the odometer reading. The sales voucher will be the only receipt 10. CardtoFee issued the Cardholder. The 10.card Cardfee Feeis set based on your choice of Tax Invoice delivery and is subject to change, see 13. If you have elected to receive your Invoice via post, the current card is $1 per month, card. youInvoice elect to receiveand your Invoice to viachange, email, the card feeelected is 50 cents per card, month. note: The card feefee is set based on yourper choice ofIfTax delivery is subject seecurrent 13. If you have to receive yourper Invoice viaPlease post, the half of thecard monthly feemonth, is charged per card, each in whichviathe cardthe is used. current fee is card $1 per per card. If youfor elect tobilling receiveperiod your Invoice email, current card fee is 50 cents per card, per month. Please note: half of theStatement monthly card fee is charged per card, for each billing period in which the card is used. 11. Z Card - Tax Invoice 11. ZNZRA Cardwill Statement - Taxeach Invoice 11.1 issue, twice month, a Z Card account statement in the form of a Tax Invoice. The usual date for issue is 1st and 15th of each month, or 11.1 NZRA will issue, twice each a ZInvoice Card account statement in the form of card a Taxfees, Invoice. The usual date for is 1st and 15thand of each the first business day falling after month, that. The summarises all your purchases, other fees (if any), fuelissue discounts applied GST. month, You areor the first to business fallingshown after that. TheTax Invoice summarises all your purchases, other fees (if any), fuel discounts applied and GST. You are required pay theday amount on the Invoice in accordance with the directcard debitfees, arrangements. required tothe payvagaries the amount shown on the Tax systems, Invoice inspam accordance withnetwork the direct debit arrangements. 11.2 Due to of the internet, email filters and security settings, NZRA cannot be responsible for non-delivery of email 11.2 Due to You the vagaries of the internet, email systems, spam filters and network security settings,the NZRA be responsible email Tax Invoices. are responsible for monitoring email and detecting non-receipt. NZRA reserves rightcannot to charge a fee of $2for pernon-delivery replacementofTax Tax Invoices. responsible for monitoring and detecting non-receipt. NZRA reserves the right to charge a fee to of your $2 per replacement Taxor Invoice. PleaseYou askare your network administrator toemail add "retail.org.nz", "[email protected]" and "[email protected]" safe senders’ list Invoice.white Please askThe your network to add "[email protected]" and "[email protected]" to your safe senders’ list or domain list. Invoice will administrator be in PDF format and"retail.org.nz", you may require Adobe Reader to open, view and print it. domain white list.ofThe Invoice will be in PDF format and you may require Adobe Reader to open, view and print it. 12. Non-Payment Account of Account In12. theNon-Payment event that your Z Card Account remains unpaid, the NZRA has the right to immediately prevent further purchase by the cards issued on that account, the event that your Z Card Account remains unpaid, the activities NZRA hasin the righttotorecover immediately preventoffurther purchase theany cards issuedcharges on thatoraccount, toIncharge interest on the balance and undertake collection order the amount debt and interestbyand further to charge made. interest onlegal the balance undertake collection activities in order to recoveramounts the amount ofby debt and any further charges or purchases Any fees or and other costs which the NZRA may incur in recovering owed youand willinterest be payable by you. Interest on overdue purchases made.atAny or other costs the NZRA incurFor in recovering amounts you will be by ‘finance you. Interest overdue amounts accrues thelegal ratefees of two and one halfwhich per centum permay month. the purposes of the owed Creditby Contracts Actpayable 1981, the rate’ on is 30 per amounts at the rate of two and one half per centum per month. For the purposes of the Credit Contracts Act 1981, the ‘finance rate’ is 30 per centum peraccrues annum. centum annum. 13. Fees, per Charges and Rebates 13.ZFees, andsubject Rebatesonly to card fees. However, Z Energy and NZRA reserve the right to introduce other fees or vary fees and rebates from time The CardCharges is currently Z Card currently only to card fees.ofHowever, Z Energyof, andorNZRA reserve theand right to introduce other fees or vary fees and rebates from time toThe time. We is will give yousubject 90 days written notice the introduction change in, fees rebates. to Inability time. Weto will give you 90 days written notice of the introduction of, or change in, fees and rebates. 14. supply Z Motor Fuel 14. Inability Z Motor Neither NZRAto norsupply Z Energy shall Fuel be responsible for any loss or inconvenience which may be caused by NZRA, Z Energy or any other Z Card Merchant’s Neitherto NZRA northe Z Energy shall berequirements responsible for loss fuel, or inconvenience be caused NZRA, Z time Energy any other Merchant’s inability supply Cardholder’s forany motor lubricants or which other may products at anyby particular or or place, for anyZ Card reason whatsoever. inability to supply the Cardholder’s requirements for motor fuel, lubricants or other products at any particular time or place, for any reason whatsoever. 15. Changes in Conditions 15.NZRA Changes in Conditions The reserves the right to vary, delete or supplement the Z Card terms and conditions for use upon no less than 30 days written notice to you. The NZRA reserves right toof vary, delete or supplement the Z Card terms and conditions for sent use upon no of less thanemail 30 days written notice to you. Without limiting anythe definition written notice, for the avoidance of doubt, it includes notice by way post, or facsimile. Without limiting any definition of written notice, for the avoidance of doubt, it includes notice sent by way of post, email or facsimile. 16. Change of Address 16.must Change of Address You notify the NZRA of any change in your business name, email address, postal address or street address of business and directorship (in the case of must notify the NZRA of any change your business name, email address, postal address or street address of business and directorship (in the case of aYou company member) immediately upon a in change being effected. a company member) immediately upon a change being effected. 17. Notice to Z Card accountholders 17. Notice to Z Card When the NZRA gives accountholders written notice to you under 13 or 15, the NZRA will deliver the notice to the latest address, email address, facsimile, etc. as recorded When the NZRA gives written notice Once to youtransmitted, under 13 orposted 15, theor NZRA will deliver the notice to the and latest address, facsimile, etc.received as recorded for you in the NZRA Z Card database. otherwise delivered, the notice itsaddress, contentsemail will be taken to have been 3 for you in the NZRA Z Card database. Once transmitted, posted or otherwise delivered, the notice and its contents will be taken to have been received 3 days later by you. The first use of a Z Card after notice is given indicates your acceptance of the condition(s) or change in condition(s) as notified. days later to bythe you.NZRA The first use of a Z Card after notice is given indicates your acceptance of the condition(s) or change in condition(s) as notified. 18. Notice 18. Notice to the NZRA Where you give written notice to NZRA under the terms and conditions of use, the notice shall not be effective until that notice is received and Where you give written notice to NZRA under the terms and conditions of use, the notice shall not be effective until that notice is received and acknowledged. acknowledged. 19. Taxes and Duties 19. Taxes and Duties Unless precluded by legislation, NZRA reserves the right to charge your Z Card Account with Government rates, taxes or charges which now are or which in Unless precluded by legislation, NZRA reserves the right to charge your Z Card Account with Government rates, taxes or charges which now are or which in the future may be imposed or charged upon your Z Card transactions whether or not you are primarily liable for the impost or charge. the future may be imposed or charged upon your Z Card transactions whether or not you are primarily liable for the impost or charge. March 2012 March 2012

Page 33 of of 33 Page

NZRA ZCARD CARD NZRA ZZCARD NZRA PO Box 12 086, Wellington. Phone 04 0830 805 0830 Fax805 04 0831, 805 0831, e-mail [email protected] PO Box 12 086, Wellington. Phone 04 805 0830 Fax 04 805 0831, e-mail [email protected] PO Box 12 086, Wellington. Phone 04 805 Fax 04 e-mail [email protected]

use only Office use only Offi ceOffi useceonly

Membership Membership No:No: No: Membership MEMBERSHIP: MEMBERSHIP: MEMBERSHIP:

NZ RETAILERS ASSOCIATION NZ RETAILERS ASSOCIATION NZ RETAILERS ASSOCIATION BUSINESS NEW ZEALAND BUSINESS NEWNEW ZEALAND BUSINESS ZEALAND

CONTACT NAME: CONTACT NAME: CONTACT NAME:

NZ TOURISM INDUSTRY ASSOCIANZ NZ TOURISM INDUSTRY ASSOCIADAY TIME PHONE: TOURISM INDUSTRY ASSOCIADAYDAY TIME PHONE: TIME PHONE:

AUTHORITY AUTHORITY TOTOTO AUTHORITY

NAME OF ACCOUNT: NAME OF ACCOUNT: NAME OF ACCOUNT:

ACCEPT ACCEPT ACCEPT

CUSTOMER TO TO COMPLETE BANK/BRANCH NUMBER AND CUSTOMER TO COMPLETE BANK/BRANCH NUMBER CUSTOMER COMPLETE BANK/BRANCH NUMBER ANDAND ACCOUNT NUMBER AND SUFFIX OF OF ACCOUNT TO TO BE DEBITED ACCOUNT NUMBER AND SUFFIX OF ACCOUNT TODEBITED BE DEBITED ACCOUNT NUMBER AND SUFFIX ACCOUNT BE

BankBankBank Branch Number Branch Number Branch Number

Account Number Account Number Account Number

DIRECT DEBITS DIRECT DEBITS DIRECT DEBITS (Not(Not to operate as an (Not to operate to operate as anas an assignment or agreement) assignment or agreement) assignment or agreement)

SuffiSuffi x xSuffix

To:To: The Manager (please print full postal address clearly forfor window envelope) The Manager (please print full postal address clearly window envelope) To: The Manager (please print full postal address clearly for window envelope) BANK BANK BANK BRANCH BRANCH BRANCH

AUTHORISATION CODE AUTHORISATION CODECODE AUTHORISATION

0 0 30 3 03 0 60 6 96 9 99 9 3 93

ADDRESS: ADDRESS: ADDRESS:

3

(P O(P Box) O(PBox) O Box) DATE: DATE:DATE:

TOWN/CITY TOWN/CITY TOWN/CITY

I/We authorise youyou until further notice in writing to debit account with you allyou amounts which I/We authorise until further notice in writing to debit my/our account with you all amounts which I/We authorise you until further notice in writing to my/our debit my/our account with all amounts which TheThe New Zealand Retailers Association of New Incorporated New Zealand Retailers Association of New Zealand Incorporated The New Zealand Retailers Association ofZealand New Zealand Incorporated (Hereinafter referred to astothe (Hereinafter referred as Initiator) theasInitiator) (Hereinafter referred to the Initiator)

thethe registered Initiator of the Authorisation Code, may initiate by by Direct Debit. registered Initiator of the above Authorisation Code, may initiate Direct Debit. the registered Initiator ofabove the above Authorisation Code, may initiate by Direct Debit. I/We acknowledge and accept that the bank accepts this authority only upon the conditions listed on thethe I/We acknowledge andand accept that thethe bank accepts thisthis authority onlyonly upon the conditions listed on I/We acknowledge accept that bank accepts authority upon the conditions listed on the reverse of this form. reverse of of this form. reverse this form. INFORMATION TO TO APPEAR ONON MY/OUR BANK STATEMENT (TO(TO BE COMPLETED BY INITIATOR) INFORMATION APPEAR MY/OUR BANK STATEMENT BE COMPLETED BY INITIATOR) INFORMATION TO APPEAR ON MY/OUR BANK STATEMENT (TO BE COMPLETED BY INITIATOR) PAYER PARTICULARS PAYER PARTICULARS PAYER PARTICULARS

PAYER CODE PAYER CODE PAYER CODE

PAYER REFERENCE PAYER REFERENCE PAYER REFERENCE

N NZ NZR ZRA RA_ A_Z __Z C _Z C DD _A CAR ARD R NAME OF ACCOUNT (CUSTOMER TO COMPLETE) NAME OF ACCOUNT (CUSTOMER TO COMPLETE) NAME OF ACCOUNT (CUSTOMER TO COMPLETE)

AUTHORISED SIGNATURE(S) AUTHORISED SIGNATURE(S) AUTHORISED SIGNATURE(S)

Approved Approved Approved 06990699 0699 01 0101 01 01 01

FORFOR BANK USE USE ONLY: BANK ONLY: FOR BANK USE ONLY:

DATE CHECKED RECORDED DATE CHECKED RECORDED RECEIVED: DATE BY: BY: RECEIVED: RECORDED BY: BY:CHECKED RECEIVED: BY: BY:

Original - Retain at Branch Original - Retain at Branch Original Retain atin Branch CopyCopy - Forward to- Initiator postage pre pre paidpaid and and addressed envelope provided by the Initia- Forward to Initiator in postage addressed envelope provided by the InitiaCopy - Forward to Initiator in postage pre paid and addressed envelope provided by the Initia-

BANK STAMP BANK STAMP BANK STAMP

CONDITIONS OF THIS AUTHORITY TO ACCEPT DIRECT DEBITS CONDITIONS OF THIS AUTHORITY TO ACCEPT DIRECT DEBITS 1. The Initiator: 1. The Initiator: (a) (a)

(b) (b)

Has agreed to send notice of the net amount of each Direct Debit no later than the day the Direct Debit is initiated. This notice must be Has agreed to send notice of the net amount of each Direct Debit no later than the day the Direct Debit is initiated. This notice must be provided either: provided either: (i) in writing; or (i) in writing; or (ii) by electronic mail where the Customer has provided prior written consent to the Initiator (ii) by electronic mail where the Customer has provided prior written consent to the Initiator The notice will include the following message:The notice will include the following message:‘The amount $______, was direct debited to your Bank account on (initiating date)’ ‘The amount $______, was direct debited to your Bank account on (initiating date)’ May, upon the relationship which gave rise to this Authority being terminated, give notice to the Bank that no further Direct Debits are May, the relationship which gave risereceipt to this of Authority beingthe terminated, notice this to the Bank that further Direct Debits are to beupon initiated under the Authority. Upon such notice Bank may give terminate Authority as tonofuture payments by notice to be initiated under the Authority. Upon receipt of such notice the Bank may terminate this Authority as to future payments by notice in writing to me/us. in writing to me/us.

2. The Customer may:2. The Customer may:(a) (a) (b) (b)

At any time, terminate this Authority as to future payments by giving written notice of termination to the Bank and to the Initiator. At any time, terminate this Authority as to future payments by giving written notice of termination to the Bank and to the Initiator. Stop payment of any Direct Debit to be initiated under this Authority by the Initiator by giving written notice to the Bank prior to the Stop payment of any Direct Debit to be initiated under this Authority by the Initiator by giving written notice to the Bank prior to the Direct Debit being paid by the Bank. Direct Debit being paid by the Bank.

3. The Customer acknowledges that:3. The Customer acknowledges that:(a) (a)

(b) (b) (c) (c) (d) (d)

(e) (e)

This authority will remain in full force and effect in respect of all Direct Debits passed to my/our account in good faith notwithstanding This authority remain in full force and effof ectthis in authority respect of all actual Direct notice Debitsofpassed to my/our account in Bank. good faith notwithstanding my/our death, will bankruptcy or other revocation until such event is received by the my/our death, bankruptcy or other revocation of this authority until actual notice of such event is received by the Bank. In any event this authority is subject to any arrangement now or hereafter existing between me/us and the Bank in relation to my/our Inaccount. any event this authority is subject to any arrangement now or hereafter existing between me/us and the Bank in relation to my/our account. Any dispute as to the correctness or validity of an amount debited to my/our account shall not be the concern of the Bank except in so Any dispute as to the has correctness validity of an amount debited to my/our account shalllies not be theme/us concern theInitiator. Bank except in so far as the Direct Debit not beenor paid in accordance with this authority. Any other disputes between andofthe far as the Direct Debit has not been paid in accordance with this authority. Any other disputes lies between me/us and the Initiator. Where the Bank has used reasonable care and skill in acting in accordance with this authority, the Bank accepts no responsibility or Where Bank has liabilitythe in respect of: used reasonable care and skill in acting in accordance with this authority, the Bank accepts no responsibility or liability in respect of: - the accuracy of information about Direct Debits on Bank statements - the accuracy of information about Direct Debits on Bank statements - any variations between notices given by the Initiator and the amounts of Direct Debits - any variations between notices given by the Initiator and the amounts of Direct Debits The Bank is not responsible for, or under any liability in respect of the Initiator’s failure to give written advance notice correctly nor for The is not responsible for, ofornotice under by anyme/us liability respect the Initiator’s to situation give written notice correctly nor and for the Bank non-receipt or late receipt for inany reasonofwhatsoever. In failure any such the advance dispute lies between me/us the non-receipt or late receipt of notice by me/us for any reason whatsoever. In any such situation the dispute lies between me/us and the Initiator. the Initiator.

4. The Bank may:4. The Bank may:(a) (a)

(b) (b) (c) (c)

In it’s absolute discretion conclusively determine the order of priority of payment by it of any monies pursuant to this or any other auInthority, it’s absolute conclusively determine ofon payment by it of any monies pursuant to this or any other aucheque discretion or draft properly executed by me/usthe andorder givenoftopriority or drawn the Bank. thority, cheque or draft properly executed by me/us and given to or drawn on the Bank. At any time terminate this authority as to future payments by notice in writing to me/us. At any time terminate this authority as to future payments by notice in writing to me/us. Charge its current fees for this service in force from time-to-time. Charge its current fees for this service in force from time-to-time.

11/2010 11/2010

NEW ZEALAND RETAILERS ASSOCIATION ORDER NEW Z CARD NEW ZEALAND RETAILERS ASSOCIATION Please read the security ORDER NEW Z CARDnotes overleaf before completing this form Company Please readDetails the security notes overleaf before completing this form Business Name Company Details

Z Card Account Number

Business Name Contact Person:

ZTelephone: Card Account Number

TBA TBA

Contact Person: Telephone: Please order a new card on our account as (tick) one of three options:

1Please Personal Closed Card order a new card on our account as (tick) one of three options: Reg Number: [ Card 1Vehicle Personal Closed

]

Vehicle Make Model: [ [ Vehicle Reg&Number:

]]

Vehicle Body Vehicle Make & Style: Model:[ [

]]

Vehicle Colour: Vehicle Body Style:[ [

]]

VehicleOpen Colour: [ Personal Card

2 2

Cardholder Name: Cardholder Name:

]

Personal Open Card Any Vehicle (Pool Cars)

Cardholder Name:

Any Vehicle (Pool Tick Cars)

Cardholder Name:

Tick

3

Vehicle Card

3Vehicle Vehicle Card [ Reg Number:

]

Vehicle Make Model: [ [ Vehicle Reg&Number:

]]

Vehicle Body Vehicle Make & Style: Model:[ [

]]

Vehicle Colour: Vehicle Body Style:[ [

]]

Vehicle Colour: [

]

Product Categories - please tick ZX Premium Unleaded Product Categories

Oil - please tick

ZZX 91 Premium UnleadedUnleaded

Car Oil Wash

Z 91 Unleaded Diesel

Car Wash Vehicle Servicing

Autogas Diesel LPG

Any Driver (Pool Drivers) Any Driver Tick (Pool Drivers) Tick

Management Controls

Shop/All Services Equipment & Shop/All Services Vehicle Hire Equipment & Vehicle Hire

Vehicle Servicing

Autogas LPG

Usage Limits - please choose your limits

Compulsory PIN? Management Controls Compulsory PIN? Select your own PIN Compulsory Select your own Odometer PIN entry? Compulsory Odometer entry?

Daily Card Limit -your choose enough to fill the tank, or perhaps fill twice, choose limits $ Usage Limits - please for the driver covering longer distances - $50 to $5,000 Daily Card Limit - choose enough to fill the tank, or perhaps fill twice, $ Monthly - $100 to $30,000 for the Card driverLimit covering longer distances - $50 to $5,000 $ Monthly Card Limit - $100 to $30,000

$ Authority - to be completed by Owner/Director/Partner/Manager I Authority hereby request that this Z Card is issued I confirm that I have the requisite authority. - to be completed by and Owner/Director/Partner/Manager I confirm I have read and understood the security notes and Conditions of Use (pages 2 and 3) and that I hereby request thatto this Z request Card is issued I confirm thatConditions I have theofrequisite authority. cards issued pursuant this will be and subject to those use I confirm I have read and understood the security notes and Conditions of Use (pages 2 and 3) and that cards issued pursuant to this request will be subject to those Conditions of use Name of Owner/Director/Partner/Manager Name of Owner/Director/Partner/Manager

Date Date

Signature of Owner/Director/Partner/Manager Please return 1 with your Z Card Account Application Form Signature of page Owner/Director/Partner/Manager Please return page 1 with your Z Card Account Application Form

March 2012

Page 1 of 3

March 2012

Page 1 of 3

Security Note - Card Details and Cardholder Details There are a number of ways a card may be issued and these are ranked in order of security 1 Named Cardholder, Specific Vehicle This is very secure, particularly when coupled with a compulsory PIN. The vehicle is identified by registration number, make & model, colour and body type 2 Named Cardholder, Any Vehicle Still reasonably secure, more so if coupled with compulsory PIN. But this also provides flexibility, for when the cardholder may need to use another work vehicle or a hire car.

Security No

There are a num ranked in order 1 Named Card This is ver by registra

2 Named Card 3 Any Driver, Specific Vehicle Still reaso Do not leave the card in the Pool Vehicle for when t This is useful for Pool Vehicles. You should request a PIN for added security. However, for situation where only 2 or 3 people use the pool vehicle, you could consider issuing each driver with their own 3 Any Driver, card and PIN for added security. Do not le This is use Vehicle Body Types where onl card and P Choose from one of the following styles: Boat Bus Camper Van Coach Compactor Convertible Coupe Crane Cruiser Digger Double Cab Ute Excavator Forklift Fuel Trailer Grader Hatchback Hearse Launch Limousine Loader Logstacker Mini Bus

Motorcycle Mower Outboard Motor Paver People Mover Roller Scooter Sedan Ship Special Purpose Station Wagon Sports Utility Vehicle (SUV) Tank Tanker Tipper Tractor Tractor Mower Trailer Truck Utility Van Wagon (Estate)

Fees We are pleased to remind members that Association Shell Card charges: - NO account fees - NO transaction fees - NO set up fees - NO fees for replacing cards There is a card fee of 50 cents per card per invoice period. THIS REDUCES TO only 25 cents when you choose to receive your Shell Card invoice by email. Please contact us for information.

Vehicle Bod

Choose from on

Boat Bus Camper Van Coach Compactor Convertible Coupe Crane Cruiser Digger Double Cab U Excavator Forklift Fuel Trailer Grader Hatchback Hearse Launch Limousine Loader Logstacker Mini Bus

Fees

We are pleased t - NO account fee - NO transaction - NO set up fees - NO fees for rep

There is a card fe TO only 25 cents email. Please con March 2012

Page 2 of 3 March 2012

Page 2 of 3

Conditions Conditions of Use

For the current conditions of Use/Terms and Conditions governing the use of the NZRA Z Card, please visit our website www.retail.org.nz and click on the Z Energy logo.

For the curre NZRA Z Card logo.

March 2012 March 2012

Page 3 of 3

Page 3 of 3

NZRA Z CARD

FlyBuys Notification Form The NZRA Z Card allows you to earn points on your cumulative fuel purchases at Z Energy Service Stations.

NZRA Z CARD

Please complete this form and return by post, fax or scan-and-email.

FlyBuys For further details, please visit our website www.retail.org.nz and click on the Z Energy logo. Notification Form The NZRA Z Card allows you to earn points on your cumulative fuel purchases at Z Energy Service Stations. Please complete this form and return by post, fax or scan-and-email. For further details, please visit our website www.retail.org.nz and click on the Z Energy logo.

Company (Legal) Name:

Z Card Account Number:

or:

New Account (application form attached)

Please complete this form with your FlyBuys number only if you are authorised to do so (i.e. you are the business owner or manager)

Company (Legal) Name:

Your FlyBuys® member number

Z Card Account Number:

or:

New Account

(application form attached) I certify that I am authorised to make this request on this account and to claim the FlyBuys points accruing from the transactions on this account. Please complete form with your FlyBuys number only if you are authorised to do so I confirm that allthis foregoing statements are true and complete. (i.e. you are the business owner or manager)

Your FlyBuys® member number Full name

Signed

Date

March 2012

I certify that I am authorised to make this request on this account and to claim the FlyBuys points New Retailers Association accruing from theZealand transactions on this account. Incorporated, PO Box 12 086, Wellington 6144 I confirm that all foregoing are true Phone statements 04 805 0830 Fax 04and 805complete. 0831 Email [email protected]

Full name

Signed

Date

New Zealand Retailers Association Incorporated, PO Box 12 086, Wellington 6144 Phone 04 805 0830 Fax 04 805 0831 Email [email protected]

March 2012