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The document is a Direct Debit Request Form issued by Suncorp Life & Superannuation Limited, allowing policy owners to authorize the debit of premiums from their bank account or credit card. It includes sections for personal details, account information, and signatures. Additionally, it outlines the Direct Debit Request Service Agreement, detailing the commitments of both Suncorp and the policy owner, rights regarding alterations or cancellations of debits, and contact information for inquiries.

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