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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Please use this form to start, amend or cancel a regular Direct Debit on your Macquarie Cash Management Account (CMA).
Alternatively, you or your Financial Service Professional can reduce or cancel a regular Direct Debit by contacting us.
Please return this form by 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: $
If different from ongoing Direct Debit – minimum $250.
Regular deposit amount: $
Minimum $250 per transaction.
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 cannot nominate a third party account. The account must
be in the same name as your Macquarie CMA.
Account name:
BSB:
Account number:
Second Direct Debit
First deposit amount: $
If different from ongoing Direct Debit – minimum $250.
Regular deposit amount: $
Minimum $250 per transaction.
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 cannot nominate a third party account. The account must
be in the same name as your Macquarie CMA.
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 inform
ation, 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 cannot nominate a third party account. The account must
be in the same name as your Macquarie CMA.
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
This form must contain an original signature(s) – digitally applied signatures will not be accepted. Please attach a
copy of the account holder(s) Driver’s License or Passport, if you haven’t already provided one. The identification
does not 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 do not already have a copy of the relevant offer
document you can obtain it from our website at macquarie.com.au/personal
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 07/20
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Macquarie Direct Debit Request (Australian National University)

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Completed 3 November 2021

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