Credit Card Authority by benbenzhou


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                                  Authority for payment by credit card
                                                              (GST Liable Supply)
              Fill in Section A and Section B, then mail or fax this form to the Career Development
                                       Office, with cheque if applicable.
             Section A (Authority)
              CREDIT CARD
                    I authorise payment of $              .       (AUD GST Inc) on my:

                                        Bankcard                   Mastercard                Visa                       Amex

              Cardholder's name (please print): ________________________                                   Expiry date: ______

              Card No                               -                           -                             -

              Company Name: _____________________

              Reason for payment: _________________

              Signature: __________________________                           Date signing form: _________________

               CHEQUE
                Make cheque payable to Macquarie University for the amount of $                                   .     AUD
                GST Inc)
              Section B – Customer Receipt *                    TAX INVOICE                 Credit card payment received

              *Receipts will not be posted unless specifically requested by filling out the
              information below.

              Company Name: _____________________

              Reason for payment: _________________

                                                                             Total Includes GST

              Section C (Cashier's copy)                                      Total Includes GST

              Macquarie University
              Credit card payment received

              Name: ______________________________

              Reason for payment:            _________________

              Account code: 80342021 1261

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