You are about to create a Direct Debit Request for KHM-500 Cambodia Bridge of Hope Informal School & Community Development Project
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You may enter one or both of the once off and regular debit arrangements
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Please choose a method of payment. To request a standard paper Direct Debit Authority form to sign and return, please contact the Business
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Payments will appear on your statement as HADA KHM-500
I / We authorise Ezidebit Pty Ltd ACN 096 902 813 (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*HADA KHM-500
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*HADA KHM-500 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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DDR Service Agreement(Ver )
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