Direct Debit Request

Request and Authority to debit the account named below to pay CEPU ELECTRICAL DIVISION NSW BRANCH

Employers are stopping payroll deductions. The quickest and easiest way to make sure you stay protected at work is to pay your union fee's by direct debit. By doing this you may also qualify for new benefits including the new ETU Funeral Benefit of up to $7,000*.

*conditions apply.

* Required

Title

First Name *

Last Name *

Union Membership Number

Email Address *

Employer *

Home Address *

City *

State *

Postcode *

Country *

Mobile Contact Number *

“You” request and authorise CEPU ELECTRICAL DIVISION NSW BRANCH, DEBIT USER ID: 617458 to arrange, through its own financial institution, a debit to Your nominated account any amount CEPU ELECTRICAL DIVISION NSW BRANCH, has deemed payable by You.

This debit or charge will be made through the Bulk Electronic Clearing System (BECS) from Your account held at the financial institution You have nominated below and will be subject to the terms and conditions of the Direct Debit Request Service Agreement.

Payment Type *

Recurrent Payment By
Bank Account

Account Name

BSB

Account Number

Financial Institution Branch

Financial Institution Address

Credit Card

Name On Card

Card Number

Card Expiry Month

Card Expiry Year

Card Type

I Accept *

Date *

By clicking Submit you, You have understood and agreed to the terms and conditions governing the debit arrangements between You and CEPU ELECTRICAL DIVISION NSW BRANCH as set out in this Request and in Your Direct Debit Request Service Agreement

Prove you're not a robot *