Direct debit request – Rates and charges 1Introduction2Agreement3Your details4Rated property5Authorisation6Review You can use this form to: Submit your details to begin an automated direct debit arrangement for your rates and charges with the City of Boroondara To be eligible for any of our installment options, please submit your direct debit request by 28 August for the current financial year. Before you begin: It takes about 5 minutes to complete this form and you will need to: Tell us your name, email and phone number Provide details of your bank account details, name and address of your financial institution. Read and accept the City of Boroondara Privacy Statement After you complete this form we will: Send you an email confirming we have received your request We may contact you about your request, if required. What happens with your information? We record your information on our customer databases and make it available to relevant Council staff in line with our Privacy Policy Terms and Conditions * Required1. 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 request. 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. 1.4 This facility is not available for credit card accounts. 2. Changes by us 2.1 We may vary any details of this agreements under a direct debit request at any time by giving you at least (14) days written notice. 3. Changes by you 3.1 Subject to 3.2, you may change the arrangements under a direct debit request by completing a new direct debit request (DDR) and presenting to Boroondara City Council. 3.2 You may also cancel your authority for us to debit your account at any time by giving Boroondara City Council, within seven (7) days, notice in writing before the next debit day. 3.3 You may also cancel your authority for us to debit your account at any time by giving us seven (7) days’ notice in writing before the next debit day. This notice should be given to us in the first instance. 4. Your obligation 4.1 It is your responsibility to ensure the account details on your direct debit form are correct by having your financial institution verify the details by stamping the direct debit request form. 4.2 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. 4.3 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 agreed time so that we can process the debit payment. d) your Direct Debit could also be cancelled. 4.4 It is your responsibility to check your account statement to verify that the amounts are debited from your account and are correct. 5. Dispute 5.1 If you believe that there has been an error in debiting your account, you should notify Boroondara City Council directly on 9278 4325 and confirm that notice in writing with us as soon as possible so that we can resolve your query quickly. 5.2 If we conclude as a result of our investigations that your account has been incorrectly debited by Boroondara City Council, we will refund the amount directly to you or should our investigations conclude your account has been incorrectly debited by a financial institution we will arrange for them to adjust your account (including interest and charges) and advise you in writing accordingly. 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 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 and ask them to stamp the form and verify the account details are correct. (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 Boroondara City Council, Private Bag 1, Camberwell, Vic 3124. 8.2 We will notify you by sending a notice in the ordinary post to the address shown on Boroondara City Council’s Rates database. 8.3 Any notice will be deemed to have been received two business days after it is posted. I agree to the terms set out in the above agreement I would like to: * Required register for a new direct debit arrangement for my rates and charges update my bank account details change the instalment option for my rates and charges cancel my rates and charges direct debit arrangement Your name * Required First name Last name Email * Required Enter email Confirm email Phone number * RequiredI'm submitting this request as a: * Required Business owner Property owner Company or business name * Required ABN/ACN * Required Please provide your Council property number * RequiredYou can find this number on your rates notice Address of rated property * Required Street address or PO Box Address line 2 Suburb / City State Post code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Please indicate whether you're the: * Required owner occupier Is your postal address different from the rated property address? Yes Postal address * Required Street address or PO Box Address line 2 Suburb / City State Post code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands BSB number * Required Account number * Required Name of financial institution * Required Location of branch Please select your preferred payment option: * Required 4 payments (30 September, 30 November, 28 February and 31 May) 10 payments (commences monthly from 31 August) 1 payment (debited annually on 15 February) Agreement * RequiredBy accepting this Direct Debit Request you acknowledge having read and understood the terms and conditions governing the debit arrangements between you and Boroondara City Council, as set out in this Request and in your Direct Debit Request Service Agreement. The first direct debit will take place on the last business day of the month following receipt of this notice, and will incorporate the current charge outstanding and any further outstanding charges on your debtor account which are due and payable. Subsequent debits will take place on the last business day of each month and will be for the amount owing as listed on the Monthly/Quarterly or Yearly Invoice sent to you prior or if you do not receive an Invoice, the statement issued monthly. I agree to the conditions of the direct debit agreement I have read and accept Council's Privacy Policy and understand how my information will be used. * Required Yes Please review your information. If you notice errors please use the numbered page navigation or the 'previous' button to make changes. If all information is correct, please click the 'Submit' button to complete this form. {all_fields:exclude[27]}NameThis field is for validation purposes and should be left unchanged.
