Parish Planned Giving Form

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By completing this Direct Debit Request you acknowledge having read and understood the Terms and conditions governing the debit arrangements between you and the Diocesan Development Fund as set out in the Request and in your Direct Debit Request Service Agreement.

Direct Debit Planned Giving

Enter Church Name and Suburb(*)

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I/we request and authorise Diocesan Development Fund, Debit User Identification number 268894 to arrange, through its own financial institution, for any amount Diocesan Development Fund may debit or charge you to be debited through the Bulk Electronic Clearing System from an account held at the financial institution identified below and Paid to the Debit User, subject to the terms and conditions of the Direct Debit Request Service Agreement .

My Details

Surname or Company Name(*)

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Given Names(*)

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Email(*)

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Address(*)

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Suburb(*)

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State(*)

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Postcode(*)

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Payment Details

Full Account Name

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BSB

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Account Number

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Payment Frequency(*)

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Donation Amount(*)

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Payment Authorisation

I confirm(*)

I have read the Service Agreement

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Phone(*)

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Please enter your preferred phone number that can be used during business hours should we need to contact you for any confirmation of details.

Before you press submit, please click and read the Service Agreement. Your submission of this form indicates that you (and any joint account holders, or the director and secretary if the account is held by a company, or if signing on behalf of an entity) have the authority to authorise the direct debit, have read and accept the terms of the Service Agreement and can confirm that the details on this form have been checked and are correct.

(*)

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