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					                                                         PART 1: REQUIRED INFORMATION
                                                                    PARTS A TO D T & C Version: SPMAV7                                    PART 4: PRICE PLAN (refer Part D for Pricing)
                                            Name by which this service is to be referred:                                                          Pre Paid Plan 1                       Post Paid Plan 1
                               PART A: WEB PAYMENTS                                                                                          PART D: PRICING
                                                                                                                                   Web Payments    Pre Paid Plan 2                          Post Paid Plan 2
                To select the appropriate interface, discuss the range of Change of details
                                             New Application OR                                                             (Complete Parts A and B)                                 Block Fee
                                                                                                                                                            Transaction                                Block Fee With
                       options available(Complete all parts) manager
                                         with your account                                                  Pre Paid                   Plan                   Pre Paid Plan 3         Without
                                                                                (Complete Parts that have changed)                                          Entitlement                                 FraudGuard
       MERCHANT           Brand                    Interface
                                                                                   Interface                  Web
                                                                                                           Payment               IVR Phone Payments (Complete Part C)
                                                                                                                                 Pre Paid Plan 1                3,000
                                                                                                                                                                                    FraudGuard
                                                                                                                                                                                        $800Post Paid Plan 3 $950
                                                        PART 2: APPLICANT DETAILS  selected
      APPLICATION                          SSL Browser Partnership or Proprietor Name (as applicable):
                                        Company, Trust, Redirect                            SDP
                                                                                                              Fees               Pre Paid Plan 2
                                                                                                                                 Pre Paid Plan 3 PART10,000
                                                                                                                                                                6,000
                                                                                                                                                                5: BANK DETAILS
                                                                                                                                                                                       $1,400
                                                                                                                                                                                       $2,200
                                                                                                                                                                                                            $1,700
                                                                                                                                                                                                            $2,700
                           eSec                                                                                                            An “Internet Merchant Account” from a bank is Fee  Transaction
    For taking credit card payments               HTTP Post                                 SDP                                                            Annual       Monthly
         over the phone or web          ABN/ACN/ARBN (as applicable):                                                                  required for access to Visa, MasterCard and Bankcard. Fraud
                                                                                                                                       Plan                                              Without          With
                                                                                                         Post Paid Web                                       Fee           Fee
                                                                                                                                     Which bank provides your Internet Merchant Account?
                                                                                                                                                                                      Fraud Guard            Guard
                                          Hosted Payments Page                                           Payment Fees            Post Paid
                                                                                                                               Westpac Plan 1               $395Commonwealth -                  National 50 cents
                                                                                                                                                                                         45 cents
Please return all 3Direct One this Street Server Redirect
                        pages of                Address:                                    SDP                                 Post Paid Plan 2 *          $450           $25           25 cents           30 cents
   Application to PO Box 190,                                                                         * Transaction Fee Volume St George                        ANZ                             Bank West
                                                                                                                                Discounts apply if over 5,000 transactions are processed each calendar month
   Flinders Lane Post Office,           Suburb / Town:only
                                                   MMF                                                                                    If you have received your Internet Merchant ID
                                                                                                                                       Number of
   Interface                                                                                                                                                                        Transaction Fee
    Melbourne 8009 or fax to                                                                              Transaction                   from the bank, please complete the below details:
                                                                                                                                   Transactions per
    required                                                                                                                                                      Without Fraud Guard             With Fraud Guard
                                              Secure Java 4 API                             SDP            Fee Volume Internet Merchant ID (also known as
                                                                                                                                         month
          (03)
    for Web 9629 5550.                  State:                                    Postcode:
   Payments                                                                                                                          5,001 CAIC for
                                                                                                            Discounts EB for National orto 10,000Commonwealth. 20 cents **                            25 cents **
                                               Secure Com API                               SDP                                        issue this number):
                                                                                                                           ANZ doesn‟tOver 10,000                       15 cents **                   20 cents **
   SECUREPAY USE ONLY                                                                                                      Internet apply to ALL transactions processed for the calendar month
                                                                                                      ** Discounted Transaction Fees Terminal ID
Merchant ID:                            Phone: Secure XML API                     Fax:      SDP                            (Westpac doesn‟t issue this number):
                                                                                                                                                                                            Monthly       Transaction
                       SecurePay                                                                            IVR Phone                  Plan             Set Up Fee        Annual Fee
                                     Secure Bill Hosted Payments Page                                                                           PART 6: AMEX AND DINERS                        Fee             Fee
Account Manager:                        Postal Address (if different to above):                          Payment Fees           Post Paid Plan 3            $450               $450            $25           55 cents
                                                  Data Bridge                                                              For access to American Express or Diners Club, please use these contacts
                                           (Refer Set Up Fee in Part D)                               Optional Additional Service Fees
Referrer ID:                                                                                                                AMEX / JCB: Phone 1300 363 614 Fee 4), DINERS: Phone 1300 360 500
                                                                                                      1. Verified by Visa and MasterCard SecureCode: Annual (Opt $395
                                        Web Site Address (if Web Payments selected):
                                                 Secure POS                                                               Advise thatFee $350 per Sub Account payments over the Internet via the SecurePay Network”
                                                                                                      2. Sub Accounts: Annual you will be “taking credit card
Date Received:                          www.                                                          3. Local Council Services: Annual Fee $450 for second and subsequent services
                                        Call Centre Payments Switch                         SDP                            Amex Merchant Phone Payments
                                                                                                      4. Telephony: Billed at cost for IVRID:
                                               (Refer Set Up Fee in Part D)
                                                               PART 3: CONTACT DETAILS 5.                        Bank Direct Entry is available on any Plan: Transaction Fee 20 cents per transaction
                                                                                                                               Diners Merchant ID:
TMulti Currency SPMAV7
 & C Version:     Major Currencies:           USD      GBP       JPY    HKD     NZD    6.
                                                                                       EUR                       Set Up Fee (Data Bridge and Call Centre Payments Switch): POA
   Including $A                                           Name:                                             Other Terms
 Accepted:
(Refer Note 3 in Part D)   Minor Currencies:   (Includes CAD, CHF, DEM, GRD, ITL, SGD)                                              PART 7: OPTIONAL SERVICES (refer advance Pricing)
                                                                                                            Block Fees are charged in advance on the Execution Date and subsequently in Part D forat the earlier
     Currency                                             Email:                                            of 12 months from the Execution Date or the day on which the Transaction Entitlement is fully used.
                                                                                                                                                                                         Local Council Services
                                             Operational JPY                                                                        Verified by in advance. Monthly Fees, Transaction (Complete Part G)Fees and
                                                                                                            Annual Fees are charged annuallyVisa               FraudGuard                 Fees, Set Up
    Conversion             Currencies:    USD     GBP               FRF   NZD      EUR
                                                                                                                                                                             GST. Unused Transaction Entitlements
                                                                                                            Telephony are charged monthly in arrears. All Fees exclude in Part D)
(Refer Note 4 in Part D)                                                                                                            and MasterCard             (Refer Note 2
                                                          Phone:                       Mobile:              expire at the end of 12 months.                                              CVV (free service)
                                                                                                                                    SecureCode                 Sub Accounts
                               PART B: WEB PAYMENTS                                                         Note                    (Refer Note 1 in Part D)   (Complete Part E)         Bank Direct Entry
                Discount                                      Name:                                         1. Verified by Visa and MasterCard SecureCode is only available on Direct One Hosted Payments
                                                                                                                                                                                         (Complete Part F)
     Will you be using an Application Provider?
          GeoTrust 128 bit SSL                                     Yes                No                         Page and eSec SSL Browser Redirect Interfaces. Westpac and St George accept this service.
              certificatesYes, please complete either Part (a) or Part (b):
                        If now               Technical Email:                                                                                      PART 8: ACCOUNT PAYMENT
                                                                                                            2. FraudGuard is only available on SecurePay Secure Java 4 API and Secure XML API Interfaces.
                available to                  (if different                                                 3. Multi Currency is only available on SecurePay Secure Java 4 API and Secure XML API Interfaces.
            SecurePay clients!
                                                                                                                               Have payments deducted from your bank account or credit card
                                                                                                                 National Australia accept this service.
       Part (a)                                ID
                          Application Provider to above)
                                                            Phone:                            Mobile:                          (Complete Account Payment Request)
                                                                                                            4. Currency Conversion is only available on Direct One Interfaces.
                           Application Provider Name                                                        5. Local Council Services are only available on SecurePay Secure Bill Hosted Payments Page
                                                              Name:                                              Interface.                                PART 9: AGREEMENT
                           Address
       Part (b)                                                                                                                By signing Part 9 you agree to be bound by the Terms and Conditions on page 3 of
                           Phone                                                                                               this Application.
                                              Finance         Email:
  PH 1300 786 756
           eMail
                                              (if different
                                               to above)
                                                                                                                               Authorised signature:
         SecurePay Pty Limited                                Phone:                          Mobile:                          Name:
                     PART
          ABN 92 088 101 875 C: IVR PHONE PAYMENTS                                                                             Date:
        If Phone Payments are required, please attach suggested script                                                                                                                            Page 1 of 3 pages
                                                                                                                                                                                                  Page 2 of 3 pages
                                                                       TERMS AND CONDITIONS T & C Version: SPMAV7
DEFINITIONS                                                                                                  AUTHORITY
The following words have these meanings:                                                                     The Applicant authorises SecurePay and the Bank (as applicable) to:
“Anti Fraud Checking” means a series of checks made on a Web Payment Transaction (payment only);             1. discuss any matter that relates to the establishment of an Internet Merchant Account, the provision
“Application Provider” means a third party who provides to and hosts on behalf of an Applicant an                of the Payment Services and the Applicant‟s Obligations,
application that contains an Interface marked in Part A as “SDP”;                                            2. complete and/ or correct any details in this Application, and
“Approved Application Provider” means an Application Provider who has a valid agreement with SecurePay;      3. provide where necessary a copy of this Application as evidence of the granting of such authority.
“Business Day” means a day on which trading banks are open for business in Australia;
                                                                                                             SOFTWARE (as applicable)
“Business Hours” means hours between 9am and 5pm Eastern Standard Time on Business Days;
                                                                                                             SecurePay licenses to the Applicant on a non-exclusive non-transferable basis for use on the Web Site
“Bank” means in respect of Bank Direct Entry, Westpac Bank, otherwise, the Bank specified in Part 5;
                                                                                                             during the Term, such software as is necessary to link the Web Site to the Payment System.
“Credit Card Agreement” means an agreement between the Applicant and a Bank or card scheme
provider (in the case of American Express, Diners Club and JCB) that provides credit card facilities         APPLICANT’S OBLIGATIONS
authorising the Applicant to process credit card payments;                                                   Without limiting the Applicant‟s obligations under this Agreement, the Applicant will:
“Direct Entry Agreement” means an agreement between the Applicant and the Bank that provides direct          1. comply with all reasonable directions of SecurePay relating to the Payment Services including only
entry facilities authorising the Applicant to process direct entry transactions;                                 implementing an Interface exactly to the specification of the relevant integration guide;
“Execution Date” means the date specified in Part 9;                                                         2. if hosting the Payment Services with an Application Provider, only do so with one that is an
“Fees” means amounts billable by SecurePay to the Applicant under this Application;                              Approved Application Provider; and
“FraudGuard” means the service of Anti Fraud Checking;                                                       3. comply with all technical, security and privacy standards set out by the Bank and the card scheme
“GST” means any tax payable under the „A New Tax System (Goods and Services Tax) Act 1999‟ and                   providers and provide evidence of compliance to SecurePay upon request.
any related or replacement act;
                                                                                                             WITHDRAWAL OF PAYMENT SERVICES
“Payment Services” means Transaction processing services provided by SecurePay utilising the
                                                                                                             SecurePay reserves the right to immediately and without notice to the Applicant, withdraw or temporarily
Payment System including the provision of access via the web to a merchant management facility and
                                                                                                             suspend, the Payment Services, or any part thereof, in the event that:
the distribution of emailed Transaction reports, as applicable;
                                                                                                             1. the Applicant ceases to be a party to a binding Credit Card Agreement or Direct Entry Agreement;
“Payment System” means the software and technology system known as SecurePay, eSec or Direct One
                                                                                                             2. the Applicant fails to comply with its obligations in relation to this Application;
Payments Gateway enabling a payment to be made using either a phone or a web site;
                                                                                                             3. if advised to do so by any Bank, Visa, MasterCard, Diners, Amex or JCB;
“Term” means in respect of Post Paid Plan 2 and Post Paid Plan 3, three years, and in respect of all other
                                                                                                             4. if fraud or the inability of the Applicant to meet charge backs is suspected;
plans, the earlier of the period during which the Transaction Entitlement (if any) is used and one year;
                                                                                                             5. if the Applicant is suspected of not meeting security standards set out by the Bank or card scheme
“Transaction” means a payment, pre-authorisation of a payment, refund or reversal attempted by the
                                                                                                                 providers;
Applicant or their customer, via a credit or charge card or via direct entry, as applicable; and
                                                                                                             6. this Application is terminated for any reason; or
“Transaction Entitlement” means the number of Transactions able to be processed by the Applicant
                                                                                                             7. a service upon which the Payment System relies is unavailable.
specified in Part D within the Term.
                                                                                                             LIABILITY
PAYMENT SERVICES
                                                                                                             To the full extent permitted by law, all terms, conditions, warranties, undertakings, inducements and
SecurePay agrees to provide the Payment Services to the Applicant for the purpose of processing
                                                                                                             representations relating in any way to the services provided under this Application are excluded. Without
Transactions via the Payment System.
                                                                                                             limiting this, SecurePay will not be liable for any loss or damage (including consequential loss or
SECUREPAY’S OBLIGATIONS                                                                                      damage) however caused (whether by negligence or otherwise) which may be suffered or incurred or
SecurePay will attempt to process via the Payment System Transactions made using:                            which may arise directly or indirectly in respect of any services provided under this Application.
1. any MasterCard Card issued by a member or affiliate of MasterCard International Inc, on which the
                                                                                                             GST
     MasterCard or MasterCard II marks appear, and any other card conforming to the Standards
                                                                                                             Where SecurePay is entitled to any payment under this Application, SecurePay will also be entitled to
     established by MasterCard International Inc.;
                                                                                                             recover the amount of the GST on any supply (within the meaning of the GST Legislation).
2. any BankCard issued by an Australian member or affiliate;
3. any Visa Card issued by a member or affiliate of Visa International on which the Visa marks appear,       PRIVACY LEGISLATION
     and any other card conforming to the Standards established by Visa International; and                   SecurePay undertakes to comply with the Privacy Amendment (Private Sector) Act 2000 and the
4. any duly authorised American Express, Diners Club or JCB credit card which has been approved by           National Privacy Principles in respect of the storage and handling of information.
     SecurePay,
                                                                                                             CONDITIONS PRECEDENT
5. direct entry,
                                                                                                             This Application is conditional upon the Applicant being granted a Credit Card Agreement and Direct
subject to a valid Credit Card Agreement and Direct Entry Agreement, as applicable, being in place in
                                                                                                             Entry Agreement, as applicable, and SecurePay‟s acceptance of this Application.
respect of each type of Transaction to be processed.
                                                                                                             TERM
CONFIDENTIALITY
                                                                                                             Payment Services will be provided for the Term commencing on the Execution Date and for additional
SecurePay will maintain the confidentiality of each Transaction and will not collect or otherwise deal in
                                                                                                             Terms if not otherwise terminated in writing by either party 14 days after the end of the concluding Term.
commercially sensitive information, except to the extent necessary for the Payment Services.
                                                                                                             GOVERNING LAW
FEES
                                                                                                             This Application is governed by the laws of the State of Victoria, Australia.
The Applicant must pay to SecurePay the Fees within 30 days of invoice date. Transaction Fees without
FraudGuard are charged for or deducted from the Transaction Entitlement on Transactions that are either      COMMISSION
approved or declined by the Bank. Transaction Fees with FraudGuard are charged for or deducted from          SecurePay may pay commission to any person who introduces the Applicant to SecurePay.
the Transaction Entitlement on Transactions reviewed by Anti Fraud Checking. SecurePay is not obliged
to refund any portion of the Fees in the event that this Agreement is terminated for any reason.                                                                                                    Page 3 of 3 pages
                                                                PARTS E TO G (OPTIONAL) T & C Version: SPMAV7
                                                        PART E: SUB ACCOUNTS
                                         If Sub Accounts are required, please list their specific details below:-
 Sub             Name by which Sub
                                                 Internet Merchant ID:      Internet Terminal ID:   Operational Contact details:
Account         Account is to be known
                                                                                                    Name:

                                                                                                    Email:
  1
                                                                                                    Phone:                         Mobile:

                                                                                                    Name:

                                                                                                    Email:
  2
                                                                                                    Phone:                         Mobile:

                                                                                                    Name:

                                                                                                    Email:
  3
                                                                                                    Phone:                         Mobile:

                                                                                                    Name:

                                                                                                    Email:
  4
                                                                                                    Phone:                         Mobile:

                                                                                                    Name:

                                                                                                    Email:
  5
                                                                                                    Phone:                         Mobile:


   Additional list attached if insufficient space provided above

      PART F: BANK DIRECT ENTRY (Only available via Westpac Bank)
  Please list Direct Debit User ID received from Bank:

      PART G: LOCAL COUNCIL SERVICES (refer Note 5 in Part F)
                      Indicate the specific payment types required:-
   Property & Rates                Parking Infringements         Animal Registrations
   Accounts Receivable             General Infringements                 Animal Infringements
   Waste Management
                                                                                                                                             Optional Page 4

				
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