Fillable Macquarie Direct Debit Request (Australian National University)

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Macquarie Direct Debit Request (Australian National University)

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The Macquarie Direct Debit Request (Australian National University) form is 2 pages long and contains:

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File type: PDF

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Please use this form to start, amend or cancel a regular Direct Debit on your relevant cash account with us, including the
Macquarie Cash Management Account. Alternatively, you or your Financial Service Professional can reduce or cancel a regular
Direct Debit at any time by contacting us.
Please return this form by email to transact@macquarie.com or mail to Reply Paid 85744 Sydney NSW 2001.
Account number:
Account name:
Action to be taken
New payment u go to section 2
Amend or cancel existing payment u go to section 3
Your Macquarie account details
1
Your new regular Direct Debit details
2
First Direct Debit
First deposit amount: $
Regular deposit amount: $
When would you like the initial deposit to be processed?
Immediately
Other, date:
/ /
Once-off, date:
Timing
Weekly, day of week:
Monthly, start date:
Quarterly*, start month:
Half yearly, start month:
Yearly*, start date:
Details of account to be debited
You can’t nominate a third party account. The account must be
in the same name as your Macquarie cash account.
Account name:
BSB:
Account number:
Second Direct Debit
First deposit amount: $
Regular deposit amount: $
When would you like the initial deposit to be processed?
Immediately
Other, date:
/ /
Once-off, date:
Timing
Weekly, day of week:
Monthly, start date:
Quarterly*, start month:
Half yearly, start month:
Yearly*, start date:
Details of account to be debited
You can’t nominate a third party account. The account must be
in the same name as your Macquarie cash account.
Account name:
BSB:
Account number:
You need to attach a bank statement that is less than six months old for the account you aredebiting.
Macquarie Direct Debit Request
Macquarie Bank Limited ABN 46 008 583 542 AFSL 237502
Macquarie Investment Management Limited ABN 66 002 867 003 AFSL 237492 RSEL L0001281
macquarie.com.au
Macquarie Direct Debit Request
2 of 2
For more information, please visit help.macquarie.com.au or contact Macquarie Cash on 1800 806 310 or
Macquarie Wrap on 1800 025 063.
Would you like to amend or cancel your existing Direct Debit?
Amend
Cancel
What are your existing Direct Debit details?
Regular deposit amount: $
Timing
Weekly, day of week:
Monthly, start date:
/ /
Quarterly, start month:
Half yearly, start month:
Yearly, start date:
/ /
What are your new Direct Debit details?
Regular deposit amount: $
Timing
Once-off, date:
Weekly, day of week:
Monthly, start date:
/ /
Quarterly*, start month:
Half yearly, start month:
Yearly*, start date:
/ /
Details of account to be debited
Financial institution:
Account name:
BSB:
Account number:
Details of new account being debited
You can’t nominate a third party account. The account must be
in the same name as your Macquarie cash account.
Account name:
BSB:
Account number:
If you are changing bank account details, you need to attach a bank statement that is less than sixmonths old
for the account you are debiting.
* Quarterly and yearly plans are debited at the end of the nominated month.
Amendments or cancellation of an existing Direct Debit
3
Declaration and signatures
4
You can sign this form electronically via one of our approved electronic signature providers and submit the form via
email with any additional documentation required. Please visit Help Centre to view our submission requirements and
a list of our approved electronic signature providers. Please attach a copy of the account holder(s) Driver’s License or
Passport, if you haven’t already provided one. The identification doesn’tneed to be certified.
By completing this form, you accept and agree to be bound by the terms and conditions contained in the product offer documents (as
applicable to you, which relate to the Direct Debit Request Service Agreement). If you don’t already have a copy of the relevant offer
document, you can obtain it from our website macquarie.com.au
Signature 1
Date:
/ /
Title:
Name:
Any other name known by (if applicable)
Signature 2
Date:
/ /
Title:
Name:
Any other name known by (if applicable)
FRM3137 02/21
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Macquarie Direct Debit Request (Australian National University)

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Completed 14 October 2021

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