Direct Debit Request

Direct Debit Request

Bank Copy

I/We authorise and request Bankwest, a division of Commonwealth Bank of Australia (User ID No. 473, 954 or 138471) ‘Bankwest’, until further notice in writing, to arrange for my/our account (as described in Section 2 below) to be debited as specified. If no amount is specified, the account may be debited with the loan instalment amount together with any related interest charges and loan fees.

$

Section 1 – Customer details

New Existing Cancel existing instructions? Yes No

I/we authorise and request Bankwest, a division of Commonwealth Bank of Australia (User ID No. 473, 954 or 138471) ‘Bankwest’, until further notice in writing, to arrange for my/our account (as described in Section 2 below) to be debited as specified. If no amount is specified, the account may be debited with the loan instalment amount together with any related interest charges and loan fees.

Title Given name(s) Surname

Company name (if applicable) ACN (if applicable)

State Postcode

State Postcode

Section 2 – The schedule

Note: Direct Debiting is not available on the full range of accounts. If in doubt, please refer to your financial institution. Please ensure account details are correct and that this request is signed by required number of authorised signatories.

Debit account details

Financial institution Branch

Account name(s)

BSB Account number Direct debit commencement date

Fixed Amount (do not complete if amount will vary) $ Payment details

Frequency:

Weekly Fortnightly 4 weekly Monthly Quarterly Annually Upon request

Additional options for loans only:

Interest only Standard monthly repayments

For home loans where a fixed amount is not specified, if your repayment type changes from Interest Only to Principal and Interest, Bankwest may debit an amount to cover the minimum repayment.

Credit Bankwest credit card

Account number Fixed amount $

Account Balance Statement balance Minimum payment due

Credit Bankwest account

BSB Account number

Section 3 – Acknowledgement

By signing below, I acknowledge that I have read and that I agree to the terms and conditions of the “Direct Debit Service Agreement” on the reverse of this form.

Section 4 – Direct debit request service agreement

1. Bankwest, a division of Commonwealth Bank of Australia ABN 48 123 123 124 AFSL/Australian credit licence 234945 (Bankwest) as Debit User will initiate direct debit payments in the manner referred to in the Schedule.

2. Debit payments will be made when due. Bankwest will not issue individual confirmation of payments made.

3. Bankwest will give the customer at least 14 days’ written notice if Bankwest proposes to vary details of this arrangement, including the amount and frequency of payments.

4. If the customer wishes to defer any payment or alter any of the details referred to in the Schedule, the customer must either visit a Bankwest Customer Service Centre, telephone the Bankwest Customer Help Centre on 13 17 19 or write to Bankwest at the following address: Customer Services, GPO Box E237, Perth WA 6841.

5. Any queries concerning debit payments or disputed debit payments must be directed to Bankwest as Debit User in the first instance. Customers may obtain details of the claims process by contacting the Bankwest Customer Help Centre on 13 17 19.

6. Direct debiting is not available on the full range of accounts at all financial institutions. If in doubt, the customer should check with the financial institution before completing this Direct Debit Request.

7. The customer should ensure that the account details given in the Schedule are correct by checking them against a recent statement from the financial institution at which the account is held.

8. By signing this Direct Debit Request, the customer warrants and represents that he/she/they is/are duly authorised to request the debiting of payments from the account described in the Schedule.

9. It is the customers responsibility to have sufficient funds available in the account to be debited to enable debit payments to be made in accordance with the Direct Debit Request. If there are insufficient funds, Bankwest may refuse to make the payment or defer its payment to a later date.

10. If a debit payment falls due on any day which is not a business day, the payment will be made on the next business day.

11. If any debit payment is returned unpaid, Bankwest may deduct a dishonour fee or a deferral fee (as applicable) for each unpaid item, from the source account. This may result in more than one fee being charged.

12. Customers wishing to cancel this Direct Debit Request or to stop individual debit payments must give at least 7 days’ written notice to the Bankwest Transactional Banking Unit. This may be arranged at a Bankwest Customer Service Centre or by calling the Bankwest Customer Help Centre on 13 17 19.

13. Except where the account or banking service terms and conditions permit disclosure, and except to the extent that disclosure is necessary in order to process debit payments, investigate and resolve disputed transactions or is otherwise required or permitted by law, Bankwest will keep details of the customer’s account and debit payments confidential.