Please enter your details, including the reference number given to you
You may enter one or both of the once off and regular debit arrangements
Please choose a method of payment. To request a standard paper Direct Debit Authority form to sign and return, please contact the Business
I / We authorise Business Ignite 1 Pty Ltd ACN 601 396 543 (User ID No 342190, 342191, 428198) to debit my/our account at the Financial Institution identified above through the Bulk Electronic Clearing System (BECS) in accordance with this Direct Debit Request.
Payments will appear on your statement as EZI*PHOENIX PT
By agreeing to this form, I / We authorise Ezidebit, acting on behalf of the Business, to debit payments from my specified Credit Card above, and I / we acknowledge that EZI*PHOENIX PT will appear as the merchant on my credit card statement. Furthermore, I / we agree to reimburse and indemnify Ezidebit for any successful claims made by the Card Holder through their financial institution against Ezidebit.
*This is a preview page only, no payments can be taken on this page.
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