You are about to create a Direct Debit Request for CARTRACK

Customer Details

Please enter your details

Debit Arrangement - Instructions to Accept Direct Debits

I authorise and request the debit user detailed below to debit payments from my nominated account, as specified below, at intervals and amounts as directed by CARTRACK as per the Terms and Conditions of the CARTRACK agreement and subsequent agreements.

One Time Setup Fee

$0.00

Bank Account

$0.00

Optional SMS Reminder

$0.28

Visa/Mastercard

2.3% (min $1.15)

Amex

0.00%

Failed Payment Fee

$11.50

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

Payments will appear on your statement as Ezidebit New Zeala

I/We authorize you until further notice to debit my/our account with all amounts which EZIDEBIT (NZ) LIMITED, the registered initiator of Authorization Code 0227418, may initiate by Direct Debit. I/We acknowledge and accept that the bank accepts this authority upon the conditions listed in the terms of this agreement. I confirm that I can operate and have sole authority for the nominated bank account.

Service Agreement

*This is a preview page only, no payments can be taken on this page.

Approved

2741

07 | 21

DDR Service Agreement(Ver 1.6)

Ezidebit Pty Ltd
|
NZBN: 9429035266310
|
Email: support@ezidebit.co.nz
|
Telephone: 0800 394 332
|
Fax: (4) 473 6511

featureFlag_isInitializeTrue

featureFlag_isOpenTrue