Additional Investment Direct Debit Form

Additional Investment
Direct Debit Form
Please use BLOCK letters and a black or blue pen to complete this form.
Please indicate using an “X” where appropriate. If a section does not apply to you,
please indicate using “N/A”.
Office use only
1. Member details
Account number
Title
Surname
Given name(s)
Date of birth
Address
Suburb
Mr
Mrs
/
Miss
/
Country
(if not Australia)
Postcode
Contact number
(business hours)
Email
Preferred contact
method
Ms
Fax number Phone
Email
2. Additional investment instructions
I wish to add to my:
Capital Guaranteed Bond $
,
,
.
Capital Guaranteed Mortgage Bond $
,
,
.
Conservative Growth Bond
$
,
,
.
Balanced Growth Bond
$
,
,
.
High Growth Bond
$
,
,
.
Education Savings Plan - Short Term Portfolio
$
,
,
.
Education Savings Plan - Medium Term Portfolio $
,
,
.
Education Savings Plan - Long Term Portfolio
$
,
,
.
Additional Investment / Direct Debit Form
State
3. Cheque or direct debit
I authorise payment from the following account:
Name of
Financial Institution
Account name
Branch number (BSB)
Commencing on Debit
–
/
$
/
,
and until further notice Australian Unity is to
,
Month
OR I enclose my cheque payment for $
Account number
.
Quarter
,
from the account specified each (please tick one box only)
Half-year
,
.
Year
to Australian Unity Limited
3. Authorisation
I have read and understood the Australian Unity Direct Debit Request (DDR) Service Agreement.
Signature
Date
Investor
signature
X
/
/
Please send your completed form to:
Or fax your completed form to:
Australian Unity Investments
Reply Paid 64466
South Melbourne VIC 3205
(03) 8682 5057
and send the original form to the address
indicated at left.
Contact us
Investor Services
T 13 29 39
F 03 8682 5057
Australian Unity Investments
114 Albert Road
South Melbourne Vic 3205
Additional Investment / Direct Debit Form
Website:
australianunityinvestments.com.au
Email:
[email protected]
Direct Debit form service agreement
Our commitment to you
This document sets out your rights, our commitment to you and your responsibilities to us together with where you should go for assistance in
respect of your direct debit arrangement with Australian Unity.
Initial terms of the arrangement
In terms of the DDR arrangement made between us and signed by you, we undertake to periodically debit your nominated account in accordance
with your signed authority to direct debit.
Drawing arrangements
If any drawing falls due on a non-business day, it will be debited from your account on the next business day following the scheduled drawing
date. We will give you at least 14 days written notice when we intend to make changes to the initial terms of the arrangement.
Your rights
Changes to the arrangement
If you want to make changes to the drawing arrangements, please notify us in writing at least 4 business days prior to your next scheduled
drawing date. These changes may include:
■
Deferring the drawing
■
Altering the schedule
■
Stopping an individual debit
■
Suspending the DDR
■
Cancelling the DDR completely
Enquiries
If you have any enquiries they should be directed to Australian Unity, rather than to your financial institution.
All personal customer information held by us will remain confidential except for information that may be provided to our financial institution
to initiate the drawing to your nominated account or information may be disclosed to a third party as required by law. Information may also be
provided to Australian Unity Limited or any of its wholly owned subsidiaries to enable the DDR to be effected as required by law.
Disputes
If you believe that a drawing has been initiated incorrectly, you should raise the matter directly with Australian Unity.
If you do not receive a satisfactory response from us, contact your financial institution who will respond to you with an answer to your claim:
■
within 7 business days (for claims lodged within 12 months of the disputed drawing) or
■
within 30 business days (for claims lodged more than 12 months after the disputed drawing).
You will receive a refund of the drawing amount if we can not substantiate the reason for the drawing.
Note: Your financial institution will ask you to contact us to resolve your disputed drawing prior to involving them.
Your commitment to us
It is your responsibility to ensure that:
■
your nominated account can accept direct debits (your financial institution can conform this)
■
that on the drawing date there is sufficient cleared fund in the nominated account
■
that you advise us if the nominated account is transferred or closed
If your drawing is returned or dishonoured by your financial institution, we will notify you in writing. Any transaction fees payable by us in respect
of the above may be passed on to you. Consecutive returns or dishonours may result in the direct debit facility being withdrawn.
Additional Investment / Direct Debit Form