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I / We authorise Ezidebit Pty Ltd ACN 096 902 813 (User ID No 165969) to debit my/our
account at the Financial Institution identified above through the Bulk Electronic
Clearing System (BECS) in accordance with the Debit Arrangement stated above and
this Direct Debit Request and as per the Ezidebit DDR Service Agreement (Ver 1.5)
provided at www.vahpa.asn.au.
By signing this form, I authorise VAHPA (ABN 38 106 461 384) to arrange, through
the Bulk Electronic Clearing System (BECS), payments from my nominated account above
in accordance with published membership rate schedules and/or other amounts agreed
above. By signing herein I indicate I have understood and agreed to the debit arrangements
between VAHPA and myself as set out in this Request and in the Direct Debit Service
Agreement terms and conditions available at www.vahpa.asn.au.
I/We hereby authorise Ezidebit Pty Ltd ACN 096 902 813 (Direct Debit User ID number
165969) (herein referred to as "Ezidebit") to make periodic debits on behalf of
the "Business" as indicated on the attached Direct Debit Request (herein referred
to as "the Business").
I/We acknowledge that Ezidebit is acting as a Direct Debit Agent for the Business
and that Ezidebit does not provide any goods or services (other than the direct
debit collection services to me/us for the Business pursuant to the Direct Debit
Request and this DDR Service Agreement) and has no express or implied liability
in regards to the goods and services provided by the Business or the terms and conditions
of any agreement that I/we have with the Business.
I/We acknowledge that the debit amount will be debited from my/our account according
to the terms and conditions of my/our agreement with the Business and the terms
and conditions of the Direct Debit Request (and specifically the Debit Arrangement
and the Fees/Charges detailed in the Direct Debit Request) and this DDR Service
I/We acknowledge that bank account and/or credit card details have been verified
against a recent bank statement to ensure accuracy of the details provided and I/we
will contact my/our financial institution if I/we are uncertain of the accuracy
of these details.
I/We acknowledge that is is my/our responsibility to ensure that there are sufficient
cleared funds in the nominated account by the due date to enable the direct debit
to be honoured on the debit date. Direct debits normally occur overnight, however
transactions can take up to three (3) business days depending on the financial institution.
Accordingly, I/we acknowledge and agree that sufficient funds will remain in the
nominated account until the direct debit amount has been debited from the account
and that if there are insufficient funds available, I/we agree that Ezidebit will
not be held responsible for any fees and charges that may be charged by either my/our
or its financial institution.
I/We acknowledge that there may be a delay in processing the debit if:-
(1) there is a public or bank holiday on the day of the debit, or any day after
the debit date;
(2) a payment request is received by Ezidebit on a day that is not a banking business
day in Queensland;
(3) a payment request is received after normal Ezidebit cut off times, being 4:00pm
Queensland time, Monday to Friday.
Any payments that fall due on any of the above will be processed on the next business
I/We authorise Ezidebit to vary the amount of the payments from time to time as
may be agreed by me/us and the Business as provided for within my/our agreement
with the Business. I/We authorise Ezidebit to vary the amount of the payments upon
receiving instructions from the Business of the agreed variations. I/We do not require
Ezidebit to notify me/us of such variations to the debit amount.
I/We acknowledge that Ezidebit is to provide at least 14 days? notice if it proposes
to vary any of the terms and conditions of the Direct Debit Request or this DDR
Service Agreement including varying any of the terms of the debit arrangements between
I/We acknowledge that I/we will contact the Business if I/we wish to alter or defer
any of the debit arrangements.
I/We acknowledge that any request by me/us to stop or cancel the debit arrangements
will be directed to the Business.
I/We acknowledge that any disputed debit payments will be directed to the Business
and/or Ezidebit. If no resolution is forthcoming, I/we agree to contact my/our financial
I/We acknowledge that if a debit is returned by my/our financial institution as
unpaid, a failed payment fee is payable by me/us to Ezidebit. I/We will also be
responsible for any fees and charges applied by my financial institution for each
unsuccessful debit attempt together with any collection fees, including but not
limited to any solicitor fees and/or collection agent fee as may be incurred by
I/We authorise Ezidebit to attempt to re-process any unsuccessful payments as advised
by the Business.
I/We acknowledge that certain fees and charges (including setup, variation, SMS
or processing fees) may apply to the Direct Debit Request and may be payable to
Ezidebit and subject to my/our agreement with the Business agree to pay those fees
and charges to Ezidebit.
Credit Card Payments
I/We acknowledge that "Ezidebit" will appear as the merchant for all payments from
my/our credit card. I/We acknowledge and agree that Ezidebit will not be held liable
for any disputed transactions resulting in the non supply of goods and/or services
and that all disputes will be directed to the Business as Ezidebit is acting only
as a Direct Debit Agent for the Business. I/We acknowledge and agree that in the
event that a claim is made, Ezidebit will not be liable for the refund of any funds
and agree to reimburse Ezidebit for any successful claims made by the Card Holder
through their financial institution against Ezidebit.
Ezidebit will keep your information about your nominated account at the financial
institution private and confidential unless this information is required to investigate
a claim made relating to an alleged incorrect or wrongful debit, or as otherwise
found at www.ezidebit.com.au
I/we acknowledge that Credit Card Fees are a minimum of the Transaction Fee or the
Credit Card Fee, whichever is greater as detailed on the Direct Debit Request.
a) Ezidebit to verify details of my/our account with my/our financial institution;
b) my/our financial institution to release information allowing Ezidebit to verify
my/our account details
Direct Debit Request Service Agreement
Victorian Allied Health Professionals Association ABN 38 106 461 384
This is your Direct Debit Service Agreement with the Victorian Health Professionals
Association (VAHPA) ABN 38 106 461 384 (formerly the HSU Health Professionals Vic
No. 3 Branch). It explains what your obligations are when undertaking a Direct Debit