Direct debit request form

Please complete this form to setup or change a direct debit on your bank account.

To setup a direct debit via credit card please call us on 13 10 46.

Please note you must be an account holder or authorised agent to setup or change a direct debit, and authorised to act on the bank account.

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Required fields are marked with an asterisk (*).

Account details
What type of account do you have? *
Please enter your 8 digit account number with no spaces
Direct debit details
Would you like to start, change or stop a direct debit on your account?
Please enter the details of the bank account to be debited
How would you like your account to be debited?
Please note, there is a minimum debit amount of $15
I would like my regular payments to be paid:
I would like the remainder to be debited on the due date:
To commence on or after (date):
Your details
Date of birth
Date of birth
Date of birth
Please send my electricity bill and other information by email

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