Direct debit request form - Apia 2026

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  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.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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Call or visit the website of the company you wish to set up a Pre-Authorized Debit (PAD) with to obtain a PAD Agreement and use your account information when completing the Agreement.
If youre switching to Direct Debit to pay a company where youre already a customer (for example, if you are paying them a regular one-off payment), first thing to do is get in touch with them and theyll set up the Direct Debit Instruction for you. That might be online or over the phone, or it could be by post.
Set up a direct debit Ask the organisation youll be making the payment to for a direct debit form. Fill in the direct debit form. Return the completed form to the organisation theyll do the rest.
A direct debit form is an application form that you must fill in which provides your details. This confirms that you give permission for your account to be debited.
The billing organisation will ask you for: Your name and address. The name and address of your bank or building society. Your bank or building society account number. The branch sort code of your bank or building society (see your debit card or banking app) The name(s) on the account.

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People also ask

A key difference between Direct Debits and standing orders is who organises each payment. With a Direct Debit, you give a company permission to set up regular payments from your bank account. But with a standing order, you create the payment yourself.
A Direct Debit is an instruction from you to your bank, authorising a business or organisation to collect payments from your account when they are due. You give this authorisation by completing a Direct Debit Mandate form this can be a paper form or a web page that you complete online.

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