Stratapay Direct Debit

Surname or Company Name

Given names or ABN

Address

Suburb

State

Postcode

Contact Name

Phone Number

I/We request that moneys due in terms of the payment arrangements covered by this document be drawn by StrataPay Pty Ltd (User ID 056118) under the Direct Debiting System from my/our account detailed below.

By signing this Direct Debit Request you acknowledge having read and understood the terms and conditions governing the debit arrangements between you and StrataPay Pty Ltd as set out in this Request and in your Direct Debit Request Service Agreement.

New Request

Amendment Request

StrataPay Reference Number

Proceeds to be dispersed to the following Body Corporate

RECURRING DEBITS

OPTION 1

Debit may be made upon my Telephone or Internet Authorisation together with any service charges which may apply. (To use this service phone 1300 552 311 or visit http://www.stratapay.com.au).

OPTION 2

Debit Amount $

Debit Date

Payment Type

Weekly

Fortnightly

Monthly

Quarterly

Half Yearly

OPTION 3

Debits may be made up to 5 business days prior to the due date for any amount outstanding on the account attached to the above StrataPay Reference Number together with any service charges that may apply subject to the availability of this data.

PLEASE SELECT EITHER OPTION 1 OR 2 BELOW

OPTION 1 - DIRECT DEBIT FROM BANK, BUILDING SOCIETY OR CREDIT UNION ACCOUNT

Financial institution name

Address

Suburb

State

Postcode

Name of Account

BSB Number

Account Number

OPTION 2 – PLEASE DEBIT MY CREDIT CARD INDICATED BELOW

Card Type

Name of Cardholder

Card Number

2.66% surcharge to all cards

Expiry Date

CVC