Direct Debit Request for 123 Group Pty Ltd - Abn 79 108 640 544

Customer Details
Please enter your details, including the reference number given to you by 123 Group Pty Ltd - Abn 79 108 640 544
Debit Arrangement
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 123 Group Pty Ltd - Abn 79 108 640 544 as per the Terms and Conditions of the 123 Group Pty Ltd - Abn 79 108 640 544 agreement and subsequent agreements.
Fees / Charges
One Time Setup Fee $0.00 Visa/Mastercard 2.2% (min $1.10) Optional SMS Reminder $0.00
Bank Account $0.00 Amex/Diners 4.4% (min $1.10) Failed Payment Fee $21.90
Payment Method
Please choose a method of payment.

Payment Method

Payments will appear on your statement as 123 GROUP P/L

I / We authorise Global Payments Australia 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