Voyager Direct Debit Application

Please complete the following form - All fields required. Please contact us at 09 444 4444, if you have any issues.

Your Details

Your Name

Account Number

Phone

Signing Authority

I have individual signing authority on the following bank account

More than one signature is required to operate our bank account

Download Direct Form

We cannot progress your Direct Debit application online, however you can download a Direct Debit form to sign and post back to us.

Download Direct Debit

Bank account to be debited

Name on Bank Account

Bank Account

Authorisation / Confirmation

I/We authorise you, until further notice in writing, to debit my/our account with you all amounts which Voyager Internet Limited
(Herein referred to as the Initiator) The registered Initiator of the above Authorisation Code, may initiate by Direct Debit. I/We acknowledge and accept that the Bank accepts this authority only upon the conditions listed in the terms & conditions below.

I have read the Terms & Conditions.

AUTHORITY TO ACCEPT DIRECT DEBITS

(Not to operate as an assignment or an agreement)

AUTHORISATION CODE

1211576