The Automatic Withdrawal Form is a critical document used in Australian business operations to establish recurring payment arrangements between organizations and their customers. This form enables businesses to set up direct debit facilities in compliance with Australian banking regulations and the ePayments Code. It is typically used when establishing ongoing services, subscription payments, or installment plans, requiring detailed capture of bank account information, payment terms, and explicit customer authorization. The document must align with Australian privacy laws for handling personal financial information and include clear terms for both parties regarding payment processing, dispute resolution, and cancellation rights. The form serves as a legal record of the customer's consent and the agreed payment arrangements.
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1. Account Holder Information: Customer's full legal name, contact details, and address as registered with the bank
2. Bank Account Details: Customer's bank account information including BSB, account number, and account name
3. Payment Details: Specified amount, frequency, start date, and duration of automatic withdrawals
4. Payee Information: Details of the organization/entity authorized to withdraw funds, including business name, ABN, and bank details
5. Authorization Statement: Clear declaration authorizing the automatic withdrawal and confirming understanding of the terms
6. Terms and Conditions: Standard terms including cancellation policy, processing timeframes, and dispute resolution procedures
7. Privacy Notice: Statement about how personal and financial information will be collected, used, and protected
8. Signature Block: Space for customer signature, date, and witness signature if required
1. Variable Payment Authorization: Additional section for cases where withdrawal amounts may vary, including maximum amount limits and notification requirements
2. Joint Account Authorization: Additional authorization section when the bank account has multiple account holders
3. Business Account Details: Additional fields for business customers including ABN/ACN and authorized signatories
4. Special Instructions: Section for any specific processing instructions or conditions
5. Credit Card Authorization: Alternative section for automatic payments from credit card instead of bank account
1. Schedule A - Payment Schedule: Detailed breakdown of payment dates and amounts if multiple or varying payments are involved
2. Schedule B - Fee Schedule: List of any applicable fees for the automatic withdrawal service
3. Appendix 1 - Terms and Conditions: Detailed terms and conditions if too lengthy to include in main form
4. Appendix 2 - Privacy Policy: Detailed privacy policy and data handling procedures if required
Relevant legal definitions
Clauses
Relevant Industries
Banking and Financial Services
Insurance
Utilities
Telecommunications
Property Management
Subscription Services
Education and Training
Professional Services
Non-Profit Organizations
Healthcare
Fitness and Wellness
Retail
Relevant Teams
Finance
Legal
Compliance
Customer Service
Operations
Administration
Risk Management
Account Management
Payment Processing
Document Control
Relevant Roles
Financial Controller
Accounts Receivable Manager
Compliance Officer
Legal Counsel
Customer Service Manager
Banking Operations Manager
Finance Manager
Business Development Manager
Subscription Services Manager
Administrative Officer
Contract Administrator
Payment Services Coordinator
Risk Management Officer
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