Direct Debit Form – Business Ignite Training

Customer Details

Please enter your details, including the reference number given to you

Product Name *

My Name *

Position (e.g. Director, Owner)

My Company Name T/A Bussiness Name

ABN

Email Address *

My Postal Address *

Suburb *

Postcode *

Mobile Number *

Work/Home Number

Debit Arrangement

You may enter one or both of the once off and regular debit arrangements

Once Off Debit

Debit Amount

Date

Regular Debits

Debit Amount

Starting

Frequency

Duration

Fees / Charges

One Time Setup Fee $5.50
Bank Account $1.20
Optional SMS Reminder $0.00

Visa/Mastercard 2.5% (min $1.10)
Amex 4.4% (min $1.10)
Failed Payment Fee $21.90

Payment Method

Please choose a method of payment. To request a standard paper Direct Debit Authority form to sign and return, please contact the Business

Type

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.

Service Agreement

                    1. By agreeing to the Direct Debit Request you authorise Stripe to arrange for funds to be debited from your nominated financial institution account (the "nominated account").  Stripe is acting as an agent for the Merchant and Stripe does not provide any goods or services to you.
                    2. Stripe or the Merchant will give you at least 14 days notice in writing of any changes to the terms of the drawing arrangements.
                    3. Stripe will keep information relating to your nominated account confidential in accordance with Stripe’s
                    [privacy policy](https://stripe.com/au/privacy), except wherex required for the purposes of conducting direct debits with your financial institution.  Your personal information will be transferred by Stripe to the United States.  If you do not want to provide your personal information to Stripe in connection with the
                    Direct Debit Request, Stripe will not be able to debit your nominated account.
                    4.Where the due date is not a business day Stripe will draw from your nominated financial institution account on the next business day.
                    5. It is your responsibility to:
                      1. Ensure your nominated account can accept direct debits;
                      2. Ensure that there are sufficient clear funds available in the nominated account to meet each drawing on the due date;
                      3. Advise immediately if the nominated account is transferred or closed or your account details change;
                      4. Arrange a suitable payment method if Stripe or the Merchant cancels the drawing arrangements;
                      5. Ensure that all authorised signatories nominated on the financial institution account to be debited authorise the Direct Debit Request.
                    6. Subject to the terms and conditions of your nominated financial institution account and your agreement with the Merchant, you may alter the drawing arrangements. Such advice should be received by the Merchant at least 7 business days prior to the drawing date for any of the following:
                      1. Changing your nominated account number
                      2. Deferring a drawing
                      3. Altering a DDR schedule
                      4. Cancelling the drawings completely
                      If you require further information, please contact the Merchant. Alternatively, you can also contact your financial institution.  
                    7. If you believe that there has been an error in debiting your account, you should notify the Merchant as soon as possible. The Merchant will notify you in writing of its determination and the amount of any adjustment that will be made to your nominated account (if any). Stripe will arrange for your financial institution to adjust your nominated account by the applicable amount (if any). Alternatively, you can also contact your financial institution.
                    8. The details of your drawing arrangements are contained in the above Direct Debit Request.
                    9. Stripe reserves the right to cancel the drawing arrangements if three consecutive drawings are dishonoured by your financial institution, and for the Merchant to arrange with you an alternative payment method. Please refer to the terms and conditions of your nominated financial institution account to see whether dishonour fees apply. The Merchant may charge additional dishonour fees in accordance with your agreement with the Merchant.

I agree to the Terms and Conditions of the Direct Debit Request and Service Agreement *

Once Off Debit

Regular Debits

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