Direct Debit Request for WMN-010 - Where Most Needed

Customer Details
Please enter your details, including the reference number given to you by WMN-010 - Where Most Needed
Debit Arrangement
You may enter one or both of the once off and regular debit arrangements.

Once Off Debit

Regular Debits

Fees / Charges
One Time Setup Fee $0.00 Visa/Mastercard 0.00% Optional SMS Reminder $0.00
Bank Account $0.00 Amex/Diners 0.00% Failed Payment Fee $0.00
Payment Method
Please choose a method of payment.

Payment Method

Payments will appear on your statement as HADA WMN-010

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