C4U - Direct Debit Agreement

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Request & Authorise Collect 4U to arrange through its own financial institution a debit to your nominated account. This debit will be made through the BECS or NPP and will be subject to the T&C of the Direct Debit Service Agreement.
First & Last Name*
Mobile Number*
E-mail Address*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of the Business you owe debt to*
Select a date to start payments (can't be today)*

DayMonthYear
WeeklyFortnightlyMonthly
Instalment Amount AUD$*
Bank Account
Bank Account Details*

Street Address

Street Address Line 2
I agree to the T&C and will ensure that sufficient funds are available. I understand transaction surcharges and dishonour fees apply.*

Clear
Fees & Charges (excl GST)
Once Off account setup fee of $10 applies and will be charged on your 1st payment. Each direct debit incurs 5% merchant fee, minimum 50c. Special conditions i.e. failed payment, refund and arrears fee is $17.70 each. Arrears fee will be charged at the end of the month if your account is overdue.
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