Flight Centre Mastercard Authority to Accept Direct Debits

ACCOUNT HOLDER DETAILS

Account Holder Name/s*

Your Contact Phone Number*

BANK ACCOUNT FROM WHICH PAYMENTS TO BE MADE

Bank

Branch

Account number

Suffix

AUTHORISATION CODE

0128485

TO THE BANK MANAGER

Bank:*

Branch:

Town/City

I/We authorise you to debit my/our account with the amounts of direct debits from Columbus Financial Services Limited with the authorisation code specified on this authority in accordance with this authority until further notice. I agree this authority is subject to the bank’s terms and conditions that relate to my account, and the specific terms and conditions listed below

Customer Signature/s*

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Date*

Please select your repayment option

Minimum Payment Fixed Monthly Amount Closing Balance

* When minimum is selected - Your payment will be debited from your bank on your due date

Enter your fixed monthly amount* NZ$

PAYER REFERENCE - YOUR 10 DIGIT CUSTOMER ID

PAYER PARTICULARS – YOUR NAME

SPECIFIC CONDITIONS RELATING TO NOTICES AND DISPUTES

I/We may ask my/our Bank to reverse a direct debit up to 120 calendar days after the debit is made if: i. I/we don’t receive a written notice of the amount and date of the direct debit from the Initiator; or ii. I/we receive a written notice but the amount or the date of debiting is different from the amount or the date specified on the notice.
The Initiator may only send a direct debit if you have: i. asked the Initiator to send it; and ii. agreed to the amount of the direct debit. The Initiator is required to give you a written notice of the amount and the date of each direct debit no less than the date of the debit. If the Bank dishonours a direct debit but the Initiator sends the direct debit again within 5 business days of the dishonour, the Initiator is not required to give you a second notice of the amount and date of the direct debit.
I/We may stop payment of any direct debit to be initiated under this Authority by the Initiator by giving written notice to the Initiator at least 2 working days prior to the direct debit being paid by the bank.