Step 3 – Direct Debit Request

* = Required fields.

Part A: Product & Sim Card

Product: 3G 4G Dialler with SIM
Sim Card Number:
ICCID:

Part B: Payment Arrangement

For the total amount billed for the specified period for this and any other subsequent agreements or amendments including associated fee/charges as detailed.

You will pay $5.90 +GST per month ($6.49 inc GST) for this service.

Any missed payments may be processed in the next billing cycle, or as a manual payment request if required. If the second payment attempt can't be processed then the payment agreement may get cancelled and the sim card may be deactivated. We (Ness) will notify the customer of any failed payments by email and SMS (if applicable) before we cancel or disconnect the sim card.

Direct debit payments are processed on the 30th of each month, unless it falls on a public holiday or weekend then it will be processed on the next business day. The direct debit payment in February will be processed the first business day in March.

Part C: Payment Billing Details

Bank Account Name: *

BSB Number: *

Account Number: *

Part D: Payment Billing Address

Family Or Business Name: *

Given Name: *

Address Line 1: *

Address Line 2:

Contact Number: *

Suburb: *

State: *

Post Code: *

* I Agree and clicking the 'Activate Payment by Direct Debit & Activate Sim Card' button you acknowledge and agree that:
a. You have read and agree to the Direct Debit Terms & Conditions.
b. You have read and agree to the Ness Sim conditions of use terms .
c. The information you have provided is true and correct.
d. You understand that you are agreeing to a month-to-month contract with ongoing payments, until an online sim card cancellation request is submitted.
e. You understand what this monthly payment is for.
f. You understand that it's an criminal offence to use someone elses bank details during the sim card activation.

* I / We authorise Payrix Australia Pty Ltd ABN 63 135 196 397, User ID 382220, to debit my/our account at the Financial Institution identified above through the Bulk Electronic Clearing System (BECS) in accordance to the Payment Arrangements stated above and this Direct Debit request and as per the DDR Service Agreement provided.