Please provide us with your bank account details so we can:

1. Ensure that POLi Payments are transferred directly to your bank account and
2. Establish a Direct Debit Authority on your account – this is for the POLi Transaction fees which will only come into effect when you begin processing live POLi transactions (in line with Merchant Agreement)

Please note: If your bank is not listed below, please advise us by emailing: helpdesk@polipayments.com

POLi Payments Pty Ltd Drawing Arrangement

This forms the basis of a legal agreement between you and POLi Payments Pty Ltd. It is important that the Direct Debit Request and Client Service Agreement is read and understood by you. I/we require that moneys due in relation to the agreement with POLi Payments Pty Ltd entered into on the 6/9/2023 be drawn under the Direct Debit System from my/our account conducted with .

Account details are:

Bank Name :
BSB :
Account Number :
Account Name:

I/we acknowledge that this Direct Debit Request is governed by the terms of the Client Service Agreement received from POLi Payments Pty Ltd, ABN 73 105 393 664 (Debit User ID number 326466).

Consent Name 1 *
Consent Name 2 (for dual signatory accounts)

Direct Debit Request Authorisation *

Please tick the Direct Debit Request Authorisation to proceed.

On confirmation of registration a non-editable version of the Direct Debit Request and Client Service Agreement will be delivered by email.

Please provide us with your bank account details.

Please note: If your bank is not listed below, please advise us by emailing: helpdesk@polipayments.com

Payment Services Agreement *

By ticking the above box, I confirm that I have read and understood, and agree to be bound by the POLi Payment Services Agreement (A copy of this agreement will be emailed to you following successful email verification.)