Please complete the following Direct Debit request form. A copy of the details will be sent to the email address provided. Please call (08) 7285 6350 if you have any questions.
10 Watervale Drive, Greenfields SA 5107 Phone: (08) 7285 6350
“You” request and authorise Staysafe (SA) Pty Ltd (ID446688) to arrange, through its own financial institution, a debit to your nominated account any amount Staysafe (SA) Pty Ltd, has deemed payable by you.
This debit or charge will be made through the Bulk Electronic Clearing System (BECS) from your account held at the financial institution you have nominated below and will be subject to the terms and conditions of the Direct Debit Request Service Agreement.
The payment is for: Electronic security services.
Please check with your Financial Institution to ensure the account nominated will facilitate direct debiting.
I/We have read and understood the “Service Agreement” below and acknowledge and agree to it.
By providing your Approval below and providing us with a valid instruction in respect to your Direct Debit Request, you have understood and agreed to the terms and conditions governing the debit arrangements between you and Staysafe (SA) Pty Ltd as set out in this Request and in your Direct Debit Request Service Agreement.
This is your Direct Debit Service Agreement with Staysafe (SA) Pty Ltd, ABN 85 617 016 832 & DE User ID 446688. It explains what your obligations are when undertaking a Direct Debit arrangement with us. It also details what our obligations are to you as your Direct Debit provider.
Please keep this agreement for future reference. It forms part of the terms and conditions of your Direct Debit Request (DDR) and should be read in conjunction with your DDR authorisation.
account means the account held at your financial institution from which we are authorised to arrange for funds to be debited.
agreement means this Direct Debit Request Service Agreement between you and us.
banking day means a day other than a Saturday or a Sunday or a public holiday listed throughout Australia.
debit day means the day that payment by you to us is due.
debit payment means a particular transaction where a debit is made.
direct debit request means the Direct Debit Request between us and you.
us or we means Staysafe (SA) Pty Ltd, (the Debit User) you have authorised by requesting a Direct Debit Request.
you means the customer who has signed or authorised by other means the Direct Debit Request.
your financial institution means the financial institution nominated by you on the DDR at which the account is maintained.
We will only arrange for funds to be debited from your account if we have sent to the address nominated by you in the Direct Debit Request, a billing advice which specifies the amount payable by you to us and when it is due.
*Note: in relation to the above reference to ‘change’, your financial institution may ‘change’ your debit payment only to the extent of advising us, Staysafe (SA) Pty Ltd, your new account details.
10 Watervale Drive
Green Fields SA 5107