Environment | SND
You are about to create a Direct Debit Request for Some Company 3.5
Please enter your details
You may enter one or both of the once off and regular debit arrangements
One Time Setup Fee
$3.30
Bank Account
$1.25
Optional SMS Reminder
$0.28
Visa/Mastercard
2.2% (min $1.25)
Amex/Diners
4.4% (min $1.25)
$11.90
Please choose a method of payment
Please enter your bank account details
Please enter your credit card details
Payments will appear on your statement as Some Company 3.5
I / We authorise Global Payments Australia 1 Pty Ltd ACN 601 396 543 (User ID No 342190, 342191, 428198) to debit my/our account at the Financial Institution identified above through the Bulk Electronic Clearing System (BECS) in accordance with this Direct Debit Request.
Payments will appear on your statement as EZI*Some Company 3
By agreeing to this form, I / We authorise Ezidebit, acting on behalf of the Business, to debit payments from my specified Credit Card above, and I / we acknowledge that EZI*Some Company 3 will appear as the merchant on my credit card statement. Furthermore, I / we agree to reimburse and indemnify Ezidebit for any successful claims made by the Card Holder through their financial institution against Ezidebit.
*This is a preview page only, no payments can be taken on this page.