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Rates - Direct Debit Request

Privacy

Privacy Collection Notice

This personal information in this form is collected by Toowoomba Regional Council for the purpose of assessing the request in this form and performing related functions. Council's privacy policy is available at tr.qld.gov.au/privacy.

Introduction

To complete this form you'll need a printer and scanner in order to be able to upload a signed authorisation document.

Applicant details

Title *

First name(s) *

Last name *

Phone number *

Email *

Postal address

Suburb

State

Postcode

Change of address

Is the postal address above, the postal address you currently have registered with us? *

YesNo

Please update your address with the Change of address form before continuing with this form.

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Rates - Direct Debit Request

Account details

Account used for direct debit must be a cheque or savings account. Direct debiting is not available on all accounts. If in doubt, please refer to your financial institution.

Name of financial institution *

Account holder's name *

BSB *

Account number *

Address of financial institution

Address of financial institution *

Suburb

State

Postcode

Additional details

Provide details of other people authorised to make changes to the account or other relevant details

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Rates - Direct Debit Request

Number of properties

How many properties would you like to arrange a direct debit for?

Property 1

Property address

Property address *

Suburb *

State *

Postcode

Reference number

Your reference number can be found on your rates notice.

Reference number *

Payment frequency

What is the amount to be direct debited at this frequency? *

Please explain your answer of 'Other' for payment frequency *

Direct debit dates

If you choose to have an ongoing direct debit arrangement, your account will be debited as described in this form until you provide further notice in writing.

What is the date for commencement of direct debit? *

Is this to be an ongoing direct debit arrangement? *

YesNo

Specify date to be terminated *

Property 2

Property address

Property address *

Suburb *

State *

Postcode *

Reference number

Your reference number can be found on your rates notice.

Reference number *

Payment frequency

What is the amount to be direct debited at this frequency? *

Please explain your answer of 'Other' for payment frequency *

Direct debit dates

If you choose to have an ongoing direct debit arrangement, your account will be debited as described in this form until you provide further notice in writing.

What is the date for commencement of direct debit? *

Is this to be an ongoing direct debit arrangement? *

YesNo

Specify date to be terminated *

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Rates - Direct Debit Request

Direct debit request service agreement

Rates Easy Pay is a service provided by Council which allows you to have money transferred from your bank, building society or credit union account, cheque or savings account only, to Toowoomba Regional Council for the payment of rates.

Definitions

"Account" means the account held at your financial institution from which we are authorised to arrange for funds to be debited. By signing a direct debit request you have authorised us to arrange for funds to be debited from your account.

"Agreement" means this Direct Debit Request Service Agreement between you and us.

"Us" or "User" means you have authorised Toowoomba Regional Council by signing the direct debit form.

"I" or "We" means the customer who signed the direct debit request.

"Business day" means a day other than a Saturday or a Sunday or a public holiday listed throughout Australia. Where the due date falls on a non-business day, we will draw on the next business day.

Changes by us

We may vary any details of this agreement or a direct debit request at any time by giving you at least fourteen (14) business days written notice.

Changes by you

You may change the arrangement under a direct debit request by contacting our customer service centre on 131 872 or by emailing us at info@tr.qld.gov.au.

If you wish to stop or alter a debit payment you must notify us in writing or contact our customer service centre at least two (2) business days before the next debit day.

You may also cancel your direct debit request for us to debit your account at any time by giving us two (2) business days notice in writing before the next debit day.

Stops or cancellations may be directed to your financial institution.

Dispute

If you believe that there has been an error in debiting your account, you should notify us in writing as soon as possible so that we can resolve your query. 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.

If 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 accordingly. We will also notify you in writing of the amount by which your account has been adjusted. If we conclude that the account has not been incorrectly debited, we will respond to your query by providing you with reasons and any evidence for this finding.

Confidentiality

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 secure and 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 the information.

We will only disclose information that we have about you:

a. to the extent specifically required by law;

b. for the purposes of this agreement (including disclosing information in connection with any query or claim);

c. that the Bank may require such information be provided in the event of a claim or relating to an alleged incorrect or wrongful debit.

Accounts

You should check:

a. with your financial institution whether direct debiting is available from your account as Direct Debit, through BECS, is not available on all accounts;

b. your account details which you have provided to us are correct by checking them against a recent statement;

c. with your financial institution if you have any queries about how to complete the direct debit request.

Payment frequency

Payments can be deducted from your nominated account on a date specified weekly, fortnightly or same day or same date of each month, or on a due date for the net total payable as shown on your rate/water notice. If you require other deductions on specific dates, these should be noted in 'Additional details'. Any amounts that have been paid by the issue date will be included in the balance brought forward shown on the rate notice.

Receipts for individual payments will not be issued. If insufficient payments have been made, it is your responsibility to pay the balance by the due date for the discount to be allowed.

It is your responsibility to ensure there are sufficient clear funds available in your account to allow a debit payment to be made in accordance with the direct debit request.

If you sell the property you should advise Council immediately after the contract is signed, to terminate the agreement. If another property is purchased a new authority needs to be completed for that property.

Note: Administration fees may apply to dishonoured transactions.

Notice

If you wish to notify us in writing about anything relating to this agreement, you should write to Toowoomba Regional Council, PO Box 3021, Toowoomba QLD 4350.

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 two (2) business days after it is posted.

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Rates - Direct Debit Request

Declaration

I/we, the applicant, authorises and requests that you, until further notice in writing, debit my/our account described in the schedule any amounts which the Toowoomba Regional Council ("The User") (User ID 063978) may debit of charge me/us through the Bulk Electronic Clearing System (BECS).

I/we understand and acknowledge that:

The financial institution may, in its absolute discretion, determine the order of priority of payment by it of any moneys pursuant to the request or any authority or mandate.
The financial institution may, in its absolute discretion, at any time by notice in writing to me/us, terminate this request as to future debits.
The user may, by prior arrangement and advice to me/us, vary the amount or frequency of future debits.
The information provided in this application is true and complete to the best of my/our knowledge.
Council may refuse this application if it becomes evident that any information or supporting documents provided are incomplete or false.
I/we approve of the information that has been provided in this application.

Signature

Use our Direct Debit Authorisation template

Attach a copy of your signed Direct Debit Authorisation *

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Form process

After you submit this form, a Council officer will contact you as your request is progressed. This usually occurs within three working days.

Once processed, a confirmation email will be sent to the email address provided.

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