Direct debit request form - Apia 2026

1. Click ‘Get Form’ to open the Direct Debit Request Form in the editor.
2. Begin by filling in your personal details, including your policy owner name, policy number, and postal address. Ensure all information is accurate for seamless processing.
3. Next, provide your contact numbers: home, work, and mobile. This helps Apia reach you if there are any issues with your direct debit.
4. In the payment frequency section, select how often you wish to make payments (fortnightly, monthly, or annually). If changing frequency, ensure you check the appropriate box.
5. For Part A (bank account), enter the account holder's name, financial institution details, BSB number, and account number. Don’t forget to sign and date where indicated.
6. If using a credit card (Part B), select either Visa or Mastercard. Fill in the cardholder's name, card number, expiry date, and provide your signature along with the date.
7. Review all entries for accuracy before submitting. Once completed, return the form via fax, email or mail as specified at the bottom of the document.

Start filling out your Direct Debit Request Form today for free using our platform!