DIRECT CREDIT/DEBIT request form

direct credit/debit
request form
Bell potter securities limited
Please tick the relevant box
One Off Banking Request
New or Revised Permanent Instructions
CONDITIONS
■■ The designated bank account must be in the same name/s as the Bell Potter account you are opening. Third Party accounts cannot be accepted.
■■ If a joint bank account is nominated, both parties must sign.
■■ This form is not suitable to authorise us to debit your linked cash management account.
Please complete these sections if you wish to authorise Bell Potter (Direct Debit User ID: 153461) to direct credit/debit funds from/to your
designated bank account.
BELL POTTER SECURITIES LIMITEd CLIENT DETAILS
Request and Authority to credit/debit the account named below to pay Bell Potter Securities Limited for trades
Bell Potter Account Name (e.g. Mr John Smith)
Designation (e.g. <Smith Super Fund>)
Bell Potter Equity Account Number
Bell Potter Option Account Number
Bell Potter Futures/FX Account Number
DIRECT CREDIT/DEBIT
Please complete if you wish to authorise Bell Potter to credit/debit your designated bank account
Bank Name
Branch
Account Name (e.g. Mr John Smith)
Designation (e.g. <Smith Super Fund>)
Bank BSB Number
Bank Account Number
-
Notify share registry of banking details for dividend payments (available only for CHESS Sponsored Clients Only)
AUTHORITY TO CREDIT/DEBIT
Request and authorise Bell Potter Securities Limited Debit User Identification Number 153461 to arrange, through its own financial institution,
for any amount Bell Potter Securities Limited may credit/debit or charge you to be debited through the Bulk Electronic Clearing System from
an account held at the financial institution identified above and paid to the Debit User, subject to the terms and conditions of the Direct Debit
Request Service Agreement (and any further instructions provided below).
PAYMENT DETAILS
The maximum amount to be debited at any one time is
$
Amount in words
acknowledgement
By signing this Direct Credit/Debit Request, you acknowledge having received, read and understood the terms and conditions governing the debit
arrangements between you and Bell Potter Securities Limited as set out in this Request and in your Direct Debit Request Service Agreement.
Signature Individual or Security Holder 1 or
Director or Sole Director
Date (dd/mm/yyyy)
/
AFSL No. 243480 ABN 25 006 390 772
Signature Security Holder 2 or Director
Signature Security Holder 3 or Director
/
direct debit credit request form V.040511 1
direct credit/debit
request form
DEFINITIONS
2. CHANGES BY US
■■ Account means the account
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.
■■ Agreement means this
3. CHANGES BY YOU
held at your financial
institution from which we
are authorised to arrange for
funds to be debited.
Direct Debit Request Service
Agreement between you and us.
■■ Banking 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).
■■ Us or we means Bell Potter
Securities Limited, (the Debit
User) you have authorised by
signed 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.
1.3If the debit day falls on a day
that is not a banking day,
we may direct your financial
institution to debit your
account on the following
banking day.
If you are unsure about which
day your account has or will
be debited, you should ask
your financial institution.
AFSL No. 243480 ABN 25 006 390 772
3.1 Subject to 3.2 and 3.3, you
may change the arrangements
under a Direct Debit Request
by contacting the Settlements
Supervisor on 03 9235 1614
3.2If you wish to stop or defer
a debit payment, you must
notify us in writing at least five
(5) 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 five (5) days notice in writing
before the next debit day. This
notice should be given to us in
the first instance.
4. YOUR OBLIGATIONS
4.1It 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.
4.2If 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.
4.4If Bell Potter Securities
Limited is liable to pay goods
and services tax (“GST”) on a
supply made in connection with
Bell potter securities limited
this agreement, then you
agree to pay Bell Potter
Securities Limited on demand
an amount equal to the
consideration payable for
the supply multiplied by the
prevailing GST rate.
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.
5. DISPUTE
7. CONFIDENTIALITY
5.1If you believe that there has
been an error in debiting your
account, you should notify
us directly on 03 9235 1614
(Settlements Supervisor) and
confirm that notice in writing
with us as soon as possible
so that we can resolve your
query more quickly.
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
discloser of that information.
5.2If 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.
5.3If 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
7.2 We will only disclose
information 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
8.1If you wish to notify us in
writing about anything
relating to this agreement,
you should write to:
Attention
Bell Potter Securities Limited
Settlements Supervisor
GPO Box 4718
Melbourne VIC 3001
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.
Any notice will be deemed to
have been received on the third
banking day after posting.
6. ACCOUNTS
6.1 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
direct debit credit request form V.040511 2