Regular Authorised Payment - Victoria Teachers Credit Union

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					                                                                           regular authorised
                                                                          Member Details

                                                                          Member Number

                                                                          Full Name / s

Contact Details     If you have changed any address or contact details, please contact one of our friendly Member Service Consultants on 1300 654 822.

Email Address

Telephone             Mobile                                             Home                                          Work

    New Regular Authorised Payment                                                        Amendment to Existing Regular Authorised Payment

Internal Debit From Victoria Teachers Credit Union Account:

Account Type: S1 / S2 / S9 / Other:
 (please circle / state applicable account)                                       Amount:

Payment Frequency:           Weekly / Fortnightly / Four Weeks / Monthly / Quarterly / Six Monthly / Yearly / One-off
(please circle applicable frequency)

Commencement Date:                       /       /               Until:                   /       /       Or Until Further Notice:

Internal Credit For Victoria Teachers Credit Union Account/s Only:

Member Number                                            Account Title

Account Type: S1 / S2 / S9 / Other:
                                                                                   Or Loan Type:
(please circle / state applicable account)

External Credit – Other Payee / Financial Institution

    Electronically (must provide BSB)

Payee / Account Name:
                                                                                                              There is a 24 hour processing time in crediting
                                                                                                                funds electronically to accounts held with
BSB Number:                                   Account Number:                                                           other financial institutions.
                                                                                                                     (Non-Chargeable Transactions)
Lodgement Reference:

    By Cheque (must provide name and address of recipient)

Payee / Account Name:

Name of Payee / Financial Institution:                                                                          Please note that payments sent by cheque
                                                                                                              should have a payment date 5 days before the
Payee / Institution Address:                                                                                   payment is due, to allow for postage. Cheque
                                                                                                               payments are also subject to clearance days.
                                                                           Postcode                              (Pay Per Use Chargeable Transactions)

Cheque Reference:

    By BPAY (must provide Biller Code and Reference Number)

Biller Code:
                                                                                                                Please read the Terms and Conditions for
Reference Number:
                                                                                                                     (Non-Chargeable Transactions)
Lodgement Reference
(office use only)
I/We certify the details on this form to be true, and apply for this product/service in accordance with all terms & conditions (and any amendments or additions made to
them) as detailed in the Terms and Conditions. When applying for this service the terms and conditions of regular authorised payments must be read in conjunction
with the terms and conditions of cheque payments, electronic transfers and Bpay.

Signature                                                                             Signature

Date                   /         /                                                    Date                 /         /
Refer to the Terms and Conditions available at our branches, on our website or by contacting us on 1300 654 822. These documents should be
considered before acquiring a product.

Office Use Only

RAP No:                                                                                                                      /         /
                                               Signature                                               Date

MSID004 0609

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Description: Regular Authorised Payment - Victoria Teachers Credit Union