The Debit Card Authorization Form is a fundamental financial document used across Australian businesses to establish and maintain automated payment arrangements with customers. This document is essential when setting up recurring payments, subscription services, or regular billing arrangements, providing legal authorization for a business to debit a customer's bank account. The form must comply with Australian banking regulations, including the ePayments Code and Privacy Act 1988, and typically includes detailed account holder information, specific payment terms, privacy notices, and clear authorization statements. It serves as a protective measure for both businesses and customers by clearly documenting the agreed-upon payment arrangements and terms, while ensuring compliance with relevant financial services legislation and consumer protection requirements.
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1. Form Title and Date: Clear identification of the document as a Debit Card Authorization Form with date of completion
2. Merchant Information: Legal business name, ABN, contact details, and merchant ID (if applicable)
3. Account Holder Information: Full legal name, contact details, and address of the account holder
4. Bank Account Details: Bank name, BSB, account number, and account type
5. Payment Authorization: Explicit authorization statement for direct debiting, including payment amount, frequency, and start date
6. Terms and Conditions: Standard terms covering payment processing, failed payments, and modification/cancellation procedures
7. Privacy Notice: Statement about how personal and financial information will be collected, used, and protected
8. Declaration: Confirmation that all information is correct and agreement to the terms and conditions
9. Signature Block: Space for account holder's signature, printed name, and date
1. Secondary Account Holder: Additional section for joint account holders when applicable
2. Variable Payment Authorization: Used when payment amounts may vary, including maximum amount limits and notification requirements
3. Credit Card Backup: Optional backup payment method section for failed direct debits
4. Service Description: Details of the service or goods being paid for, used when the authorization is tied to specific products or services
5. Change Notice Period: Additional terms specifying notice periods for changes to payment details, used for complex payment arrangements
1. Schedule A - Payment Schedule: Detailed breakdown of payment dates, amounts, and frequency if payments are recurring
2. Schedule B - Fee Schedule: List of applicable fees including failed payment fees and processing charges
3. Appendix 1 - Direct Debit Service Agreement: Detailed terms and conditions of the direct debit service as required by Australian banking regulations
4. Appendix 2 - Privacy Policy Extract: Relevant sections of the organization's privacy policy relating to payment information handling
Relevant legal definitions
Clauses
Relevant Industries
Retail
Financial Services
Healthcare
Education
Utilities
Telecommunications
Insurance
Professional Services
Property Management
Subscription Services
Fitness and Recreation
Charitable Organizations
Relevant Teams
Finance
Accounts Receivable
Customer Service
Legal
Compliance
Operations
Administration
Risk Management
Sales
Customer Operations
Relevant Roles
Finance Manager
Accounts Receivable Officer
Customer Service Manager
Compliance Officer
Legal Counsel
Business Development Manager
Operations Manager
Billing Coordinator
Administrative Officer
Risk Manager
Financial Controller
Sales Manager
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