Subscription Agreement
Debit Arrangement
Regular Debits
Fees / Charges
Payment Method
Please choose a method of payment
By agreeing to this form, I / We authorise Ezidebit, acting on behalf of the Business, to debit payments from my specified Credit Card above, and I / we acknowledge that Ezidebit will appear as the merchant on my credit card statement. Furthermore, I / we agree to reimburse and indemnify Ezidebit for any successful claims made by the Card Holder through their financial institution against Ezidebit.
I/We authorise Ezidebit Pty Ltd ACN 096 902 813 (User ID No 165969, 303909, 301203, 234040, 234072, 428198) to debit my/our nominated account identified above through the Bulk Electronic System (BECS) in accordance with the Debit Arrangement stated above by , and as per the Ezidebit Direct Debit Agreement Terms & Conditions.
Service Agreement