Aussie Direct Debit Request printable pdf download

Mail completed form to:

Aussie Consumer Finance Locked Bag 5026 Parramatta CBD BC NSW 2124

Fax: 1300 721 492

Aussie Direct Debit Request

I/We request you, Aussie Consumer Finance (Direct Debit User Identification Number 348448) to debit funds from my/our nominated

account at the financial institution, and according to the details, specified below.

• Aussie can only accept bank account details that are in the name of the Aussie account holder or from a joint bank account including the

name of the Aussie account holder.

• Direct Debiting is not available on all bank accounts. If in doubt, please refer to your financial institution.

• Direct Debit payments cannot be made using credit card accounts (e.g. Visa, MasterCard).

A new Direct Debit Request must be completed for each new loan. Do not use forms from current accounts. Initial all

alterations.

Customer Details

Title

(Customer 1) Full Name – AS IT APPEARS ON THE LOAN CONTRACT

Title

(Customer 2) Full Name – AS IT APPEARS ON THE LOAN CONTRACT

Loan account to which debit amounts will be credited

Local Account Number

Details of account to be debited – must not be a business account

Title

First Name / Middle Initial and Surname (e.g. John R Smith – Note: J R Smith is unacceptable)

Title

First Name / Middle Initial and Surname (e.g. John R Smith – Note: J R Smith is unacceptable)

Name and location of financial institution where your bank account is held (e.g. CBA – Richmond)

BSB Number

Account Number

*Should you not know your BSB and Account Number, please contact your financial institution.

Amount to be debited

Frequency (please tick one)

Weekly

Fortnightly

Monthly

To comment from

day days notice before first debit amount will be drawn. The final amount debited is to equal the

amount to pay out the loan account specified above.

Your authorisation

Note: Direct debiting is not available on some account types. If in doubt please refer to your financial institution.

By signing this Direct Debit Request you are confirming that all information recorded above is correct.

Customer Signature (1)

Customer Signature (2)

Date

The Aussie Personal Loan is from Aussie Consumer Finance (“Aussie”) with credit provided by Latitude Personal Finance Pty Ltd (ABN 54 008 443 810, Australian Credit Licence 392163). The Aussie logo is

a trademark of AHL Investments Pty Ltd (ABN 27 105 265 861, Australian Credit Licence 246786). Aussie is a partly-owned subsidiary of the Commonwealth Bank of Australia ABN 48 123 123 124 AFSL and

Australian Credit Licence 234945.

Aussie Direct Debit Request

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