ANU REGULAR GIVING FORM

ANU REGULAR GIVING FORM
Personal details
Title
Given name
Surname
Address
Phone
Email
Your official tax receipt, covering all donations for the financial year, will be posted to the above address in July each year.
Gift details Donations to ANU are tax deductible.
I would like to give
$
every (choose one)
month
quarter
Please start my donations in:
January
February
March
July
August
September
Please direct my gifts to:
Scholarships
Prizes
Research
University priorities
year
April
October
other
May
November
June
December
Other (Please specify which college, school, centre, endowment fund or research project you would like to
support)______________________________________________________________________________
Payment method
Regular direct debit payment
I request and authorise The Australian National University to debit or charge my nominated account at the financial
institution identified below through the Bulk Electronic Clearing System, subject to the terms and conditions of the Direct
Debit Request Service Agreement available at anu.edu.au/philanthropy/how-to-give. By signing this request, I acknowledge
that I have read and understood the terms and conditions governing the debit arrangements between me and The
Australian National University as set out in the Direct Debit Request Service Agreement.
Signature
Bank name
Account name
OR
Credit card
Visa
Card number
Name on card
Signature
Date
Branch name
BSB and account number
MasterCard
Amex
Expiry date
Please return this form to:
Endowment for Excellence
Building 3, I Block
The Australian National University
Canberra ACT 0200 Australian National University
or
F +61 2 6125 5568
For further information: T +61 2 6125 9945 or www.anu.edu.au/philanthropy
ANU is bound by the Privacy Act 1988. If you have any privacy concerns or would like to verify information held
about you, please don’t hesitate to contact us on +61 2 6125 9945. The University’s privacy policy can be found at
anu.edu.au/legal/content/privacy
Direct Debit Request Service Agreement
Definitions
Account means the account held at your financial institution from which we are authorised to arrange
for funds to be debited.
Agreement means this Direct Debit Request Service Agreement between you and us.
Business day means a day other than a Saturday or a Sunday or a public holiday listed throughout
Australia.
Debit day means the day that payment by you to us is due.
Debit payment means a particular transaction where a debit is made.
Direct debit request means the Direct Debit Request between us and you (and includes any Form
PD-C approved for use in the transitional period).
Transitional period means the period commencing on the industry implementation date for Direct
Debit Requests (currently 31 March 2000) and concluding 12 calendar months from that date.
Us or we means The Australian National University you have authorised by signing a direct debit
request.
You means the customer who signed the direct debit request.
Your financial institution is the financial institution where you hold the account that you have
authorised us to arrange to debit.
1. Debiting your account
1.1 By signing a direct debit request, you have authorised us to arrange for funds to be debited from
your account. You should refer to the direct debit request and this agreement for the terms of the
arrangement between us and you.
1.2 We will only arrange for funds to be debited from your account as authorised in the direct debit
request. We will only arrange for funds to be debited from your account if we have sent to the
address nominated by you in the direct debit request, a billing advice which specifies the amount
payable by you to us and when it is due.
1.3 If the debit day falls on a day that is not a business day, we may direct your financial institution to
debit your account on the following business day. If you are unsure about which day your account
has or will be debited you should ask your financial institution.
2. Changes by us
2.1 We may vary any details of this agreement or a direct debit request at any time by giving you at
least fourteen (14) days’ written notice.
3. Changes by you
3.1 Subject to 3.2 and 3.3, you may change the arrangements under a direct debit request by
contacting us at the Endowment for Excellence, Block I, Building 3, The Australian National
University Canberra ACT 0200. T +61 2 6125 7814 F +61 2 6125 5568 or
E [email protected]
3.2 If you wish to stop or defer a debit payment you must notify us in writing at least (14) days before
the next debit day. This notice should be given to us in the first instance.
3.3 You may also cancel your authority for us to debit your account at any time by giving us (14) days
notice in writing before the next debit day. This notice should be given to us in the first instance.
4. Your obligations
4.1 It is your responsibility to ensure that there are sufficient clear funds available in your account to
allow a debit payment to be made in accordance with the direct debit request.
4.2 If there are insufficient clear funds in your account to meet a debit payment:
(a) you may be charged a fee and/or interest by your financial institution;
(b) you may also incur fees or charges imposed or incurred by us; and
(c) you must arrange for the debit payment to be made by another method or arrange for sufficient
clear funds to be in your account by an agreed time so that we can process the debit payment.
4.3 You should check your account statement to verify that the amounts debited from your account
are correct
4.4 If National Australia Bank Limited A.C.N. 004 044 937 ("National") is liable to pay goods and
services tax ("GST") on a supply made by the National in connection with this agreement, then you
agree to pay the National on demand an amount equal to the consideration payable for the supply
multiplied by the prevailing GST rate.
5. Dispute
5.1 If you believe that there has been an error in debiting your account, you should notify us directly
at the Endowment for Excellence, Block I, Building 3, The Australian National University Canberra
ACT 0200. T +61 2 6125 7814 F +61 2 6125 5568 or E [email protected], and confirm that
notice in writing with us as soon as possible so that we can resolve your query more quickly.
5.2 If we conclude as a result of our investigations that your account has been incorrectly debited we
will respond to your query by arranging for your financial institution to adjust your account (including
interest and charges) accordingly. We will also notify you in writing of the amount by which your
account has been adjusted.
5.3 If we conclude as a result of our investigations that your account has not been incorrectly debited
we will respond to your query by providing you with reasons and any evidence for this finding.
5.4 Any queries you may have about an error made in debiting your account should be directed to us
in the first instance so that we can attempt to resolve the matter between us and you. If we cannot
resolve the matter you can still refer it to your financial institution which will obtain details from you of
the disputed transaction and may lodge a claim on your behalf.
6. Accounts
You should check:
(a) with your financial institution whether direct debiting is available from your account as direct
debiting is not available on all accounts offered by financial institutions.
(b) your account details which you have provided to us are correct by checking them against a recent
account statement; and
(c) with your financial institution before completing the direct debit request if you have any queries
about how to complete the direct debit request.
7. Confidentiality
7.1 We will keep any information (including your account details) in your direct debit request
confidential. We will make reasonable efforts to keep any such information that we have about you
secure and to ensure that any of our employees or agents who have access to information about you
do not make any unauthorised use, modification, reproduction or disclosure of that information.
7.2 We will only disclose information that we have about you:
(a) to the extent specifically required by law; or
(b) for the purposes of this agreement (including disclosing information in connection with any query or
claim).
8. Notice
8.1 If you wish to notify us in writing about anything relating to this agreement, you should write to
Endowment Office, Block I, Building 003, Australian National University, Canberra ACT 0200. Phone:
+61 2 6125 7814 Fax: +61 2 6125 5568 E-mail: [email protected]
8.2 We will notify you by sending a notice in the ordinary post to the address you have given us in the
direct debit request.
8.3 Any notice will be deemed to have been received two business days after it is posted.