FINANCIAL YEAR 201 7 201 8 MEMBER NO SURNAME FIRST NAME ADDRESS I r equest you CEPU Electrical Energy Services Division until further notice in writing to debit myour account described ID: 854714
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1 FORM OF REQUEST FOR DEDUCTING AMOUNTS TO
FORM OF REQUEST FOR DEDUCTING AMOUNTS TO ACCOUNTS BY THE DIRECT DEBIT SYSTEM FINANCIAL YEAR 201 7 - 201 8 MEMBER NO: SURNAME FIRST NAME ADDRESS I r equest you, (CEPU - Electrical, Energy & Services Division), until further notice in writing to debit my/our account described in the schedule below, any amounts which the Communications, Electrical, Electronic, Energy, Information, Postal, Plumbing and Allied Services Union of Australia - Electrical, Energy & Services Division (SA Branch) (“the U ser”) (User ID No. 061008 may debit or charge me/us through the Direct Debit System. I/We understand and acknowledge that: 1. The Bank/Financial Institution may in its absolute discretion determine the order of priority of payment by it of any moneys pursua nt to this request or any authority or mandate. 2. The Bank/Financial Institution may in its absolute discretion at any time by notice in writing to me/us terminate this request as to future debits. *Note : Direct debiting is not available on the full range of accounts, if in doubt, please refer to your bank/financial institution BSB: ACCOUNT NO: BANK/CREDIT UNION : AMOUNT TO BE DEDUCTED Fortnightly Monthly Quarterly TRADES PERSON : $ 27. 80 $ 60.25 $ 180.70 SIGNATURE ____________________________ _________________ Date:__________________________ Note : Complete all relevant details and send back to: CEPU - Electrical, Energy & Services Division, 312 South Road, RICHMOND, SA, 5033 Telephone: 8234 - 2130 – Fax: 8352 1711 312 South Road Richmond S A 5033 T: (08) 8234 2130 F: (08) 8352 1711 www.cepusa.com.au CEPU SA PROUD TO BE UNION