1
Members Equity Bank Limited ABN 56 070 887 679. AFSL and Australian Credit Licence 229500. ME0004.v11/202004/214788
Use this form to establish a new direct credit request or to change the details of an existing direct credit request from your ME account.
You can only make one direct credit request per form.
direct credit request.
Email: dcr@mebank.com.au
Any questions? Call ME on 13 15 63 or visit mebank.com.au
I/We request you to arrange for funds to be withdrawn from my/our ME account shown below and credited to the account at the financial institution shown in
section 2 in accordance with: (a) my/our instructions set out below and (b) my/our future instructions.
move money from here. section 1 – your ME account.
Account number Name(s) of account holder(s)
put money here. section 2 – nominated account details.
The details should appear as they do on your nominated account statement.
Name of financial institution
Name(s) of account holder(s)
BSB number Account number
how much money? section 3 – your instructions.
I/We would like to establish a new or additional direct credit request (not to replace existing) OR
I/We would like to change my/our existing direct credit details
Please withdraw $
from my/our account in section 1 and credit the account detailed in section 2.
On a
Once only Weekly Fortnightly Monthly frequency
Starting from
D
D
M
M
Y
Y
until further notice OR ending on
D
D
M
M
Y
Y
i/we swear! section 4 – declaration.
I/We acknowledge that this direct credit arrangement is governed by the terms of the Direct Credit Request Terms and Conditions on this form.
Print name Signature Date
D
D
M
M
Y
Y
Print name Signature Date
D
D
M
M
Y
Y
To make additional payments, change your regular payments, or cancel this Direct Credit Request, call the team @ ME on 13 15 63.
the legal stuff. section 5 – direct credit request terms and conditions.
By completing and signing this Direct Credit Request form you agree and acknowledge that:
(a) if there are sucient cleared funds in your ME account we will withdraw the requested amount from that account and send payment to your nominated
account on each day a withdrawal is to be made in accordance with your Direct Credit Request. We are not responsible for any delay in processing that
payment by the financial institution at which your nominated account is held;
(b) it is your responsibility to:
• ensure that there are sucient cleared funds in your ME account on a day a withdrawal is to be made in accordance with your Direct Credit Request;
• check that the details you have provided us of your nominated account are correct by checking them against a recent account statement;
• advise us if your nominated account is transferred, closed or if any other account details change; and
• check your account statement to verify that the amounts withdrawn from your ME account are correct;
(
c
) if there are insucient cleared funds in your ME account on a day a withdrawal is to be made in accordance with your Direct Credit Request, we:
• are not required to make any payment to your nominated account;
• may make the payment to your nominated account when sucient cleared funds are available (but we are not obliged to do this); and
• are not liable for any loss you may suer as a result of any failure or delay in payment to your nominated account;
(
d) if a da
y on which we are to make a payment to your nominated account in accordance with your Direct Credit Request is a public holiday, a Saturday or a
Sunday, we may make the payment on the next business day; and
(e) we may stop acting in accordance with your Direct Credit Request at any time:
• without notice to you if the financial institution at which your nominated account is held refuses to accept our payments; or
• by sending you written notice.
ignore this bit. ME use only.
Authority number
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