Fillable REQUEST FOR INSTALMENT PLAN WITH PAYSMART (Australian Correspondence Schools)

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REQUEST FOR INSTALMENT PLAN WITH PAYSMART (Australian Correspondence Schools)

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REQUEST FOR INSTALMENT PLAN WITH PAYSMART
All payment plans are offered through PaySmart and are by Direct Debit only. By entering into a payment plan, students are
entering a legally binding agreement to pay their fees by the due date, and are also agreeing to PaySmart’s terms and conditions.
Please check your fees and ensure you have enough funds to cover the instalment amounts.
Payment Plan Additional Information
I accept the liability for the total amount outstanding and agree to the PaySmart terms and conditions, and North Metropolitan’s
payment schedule outlined above.
Note: Payment plans are not available for short courses, recreational courses or Recognition of Prior Learning
Student Name (please print)
Date
Students under 18 years of age must print this form and have a parent/guardian
sign below. Please email the completed form to offers@nmtafe.wa.edu.au
Parent/Guardian’s Signature
Date
Direct Debit Request (All elds must be completed)
Student Name
Unit/Number and Street
Telephone Number
Student ID
BSB
number:
-
Account
number:
Card Number:
-
Type of Card:
Visa
Mastercard Expiry Date:
ACKNOWLEDGEMENT:
I/We authorise PaySmart Pty Ltd [User ID 073053] to debit my/our account in accordance to the payment details and the Service Agreement.
I/We authorise this direct debit request to remain in force until all outstanding fees are paid in full, even after withdrawing from course/units.
I/We confirm account details are correct and that this request is signed by the required number of authorised signatories.
Commencement date: Payments will be deducted on Fridays, commencing on the Friday after enrolment unless otherwise requested
Student Details MUST be completed in full:
Signature Account/Card Holder 1
Signature Account/Card Holder 2
Date
Date
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*If the account holder is not the student, please print this form and get it signed by the account holder, before submitting it.
Email to offers@nmtafe.wa.edu.au with your name and your campus in the subject line.
Campus
mm/yy
(Please tick the boxes.)
This is an arrangement with PaySmart. Any dishonour fees are payable directly to PaySmart and you will need to contact them on 1800 801
797 for any enquiries about your payment plan once it is set up.
Failure to comply with the agreed terms of payment will result in the debt being referred to a Debt Collector.
(Please tick the box.)
• Your instalment plan will commence on the Friday of your first week, unless you request to commence it earlier.
• Instalments must be debited on Fridays and must be fortnightly.
• Your total fees will be divided into 10 equal fortnightly payments. If you start paying late or your course is short than the semester, the
number of instalments will be reduced to ensure that fees are paid before your course ends.
• Once your payment plan is set up, you will receive a copy of your Paysmart contract by email with your start date and instalment amounts.
Please note: a $15 default fee applies if a payment is rejected by your bank.
Student Date of Birth
Suburb
Postcode
Please select one of the following payment options:
DIRECT DEBIT (from Bank Account):
Note: Direct debiting is not available on the full range of accounts.
If in doubt please refer to your financial institution.
Name of Account Holder:
Name of Financial Institution:
Branch (suburb):
DIRECT DEBIT (from Credit Card):
Name on card:
Bank Account/Credit Card holder contact details if different to student details
Email Address
Telephone Number
- -
Email Address
Course name
Direct Debit Request Services Agreement
On behalf of PaySmart:
(1) PaySmart (Debit User) will debit the bank account / credit card nominated in the Schedule of this Direct Debit Request as
specified. The Debit User may, by prior arrangement and advice to me/us vary the amount or frequency of future debits.
(2) Should the original terms & conditions of this authority need to be varied a minimum of fourteen days’ notice will be
provided by North Metropolitan TAFE to you. Queries arising as a result of any such variation must be notified to PaySmart two
working days prior to the debit date the variation would apply.
(3) Deferment or alteration (written or verbal) by the customer to the debiting schedule will be considered subject to the terms
and conditions of any agreement between you and North Metropolitan TAFE.
(4) If a debit item is disputed PaySmart (Debit User) or your Financial Institution must be notified immediately. PaySmart will
endeavour to resolve this matter within Industry agreed time frames. Disputed debit items resolved in favour of PaySmart will incur
an administration fee.
(5) Direct debiting through BECS is not available on all accounts. Y
ou are advised to check your account details against a
recent statement from your financial institution. If uncertain, you should check with your financial institution before completing the
DDR.
(6) When a debit day falls on a weekend and/or a national public holiday all debits for that weekend or national public holiday
will be processed on the PREVIOUS WORKING DAY
. If unsure, you should contact PaySmart (Debit User).
(7) PaySmart may, under certain provisions of the Privacy
Act 1988 give information about you to a credit reporting agency.
This information will be limited to repayments which are overdue pursuant to the terms and conditions of any contractual agreement
between you and North Metropolitan
TAFE. Y
ou “The Customer” may be liable for any costs associated with the recovery of your
overdue account, this may include, but is not limited to the following; legal fees, interest and mercantile agency collection cost.
(8) It is your responsibility to ensure cleared funds are available in your nominated bank account/credit card to meet the
direct
debit payment. If a debit is returned unpaid by your financial institution, you will be responsible for payment of the debit plus
an
additional $15.00 for return fees and administrative costs incurred by PaySmart (Debit User). If PaySmart (Debit User) has
not received instruction to the contrary from you, we will debit both the next due payment and any overdue amounts on your next
scheduled debit date.
(9) This authority shall stand pursuant to the terms and conditions of any contractual agreement between you and North
Metropolitan TAFE.
The administration only of this authority is conducted by PaySmart (Debit User) acting as a billing agent for
North Metropolitan
TAFE.
The services provided by PaySmart are administrative only and do not extend to the provision of any
services or benefits provided by North Metropolitan
TAFE.
This authority shall be interpreted and enforced pursuant to the laws of
the state of Queensland.
(10) T
o stop or cancel a direct debit it is recommended that you contact North Metropolitan TAFE in the first instance.
The
terms
and conditions or any agreement between you and North Metropolitan TAFE must be complied with. However, if a dispute
occurs
between you and North Metropolitan
TAFE all enquiries regarding a stop or cancellation of a direct debit should be directed
to either
PaySmart (Debit User) or your own financial institution.
(11) Collected funds are held in trust until disbursement. In event of fraud where PaySmart is not at fault, PaySmart will be free
of any legal liability.
(12) No account records or account details will be disclosed to any person or persons except where such information is
required in connection with any claim relating to an alleged incorrect or wrongful debit.
(13) All enquiries in relation to refunds must be directed to North Metropolitan TAFE.
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V3.0 August 2019
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REQUEST FOR INSTALMENT PLAN WITH PAYSMART (Australian Correspondence Schools)

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Completed 7 September 2020

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