Australian Direct Deposit Enrollment Form Completion Instructions

• Enrollment Form - HTML Version
• Enrollment Form - PDF Version (.pdf 151Kb)

Introduction

A direct deposit form has been designed to support the capture of key information from pensioner's wishing to enroll on direct deposit in Australia. The following is a step by step procedure developed to guide the pensioner in the proper completion of the form.

Completion Instructions

The Australian enrollment form is divided into three sections. They are :

• Part A - Pensioner Identification Information;
• Part B - Pension Program Identification; and
• Part C - Identification of the Financial Institution.

Part A - Pensioner Identification Information :

Part A provides space for you to identify your name, address and telephone number. The following is a step by step procedure.

Step 1 and 2 :

Enter your surname and given name and initial(s) in the boxes provided. One letter per box. Please use capital letters.

Step 3 :

Enter your address information including the name of the city and country.

Step 4 :

Confirm if the address is new by entering () in yes or no.

Step 5 :

Enter your area code code and telephone number in the event that we may need to contact you to seek clarification on the information provided.

You have now completed Part A - Pensioner Identification Information.

Part B - Pension Program Identification :

Part B provides a mechanism for you to specify the payment(s) you want deposited directly into your Australian account. To enroll, check () the appropriate box and include one of the following in the space provided : your social insurance number, contract number, file number, pension number, or personal record identifier.

The department responsible for your pension program will use this information to match your entitlement and to issue the requested electronic payment.

[Long description of Part B Image - Program Identification]

Step 1 :

Check off the box(es) for the payment(s) you wish to receive by direct deposit.

Step 2 :

Enter the number associated to each type of payment you wish to receive.

You have now completed Part B - Pension Program Identification.

Part C - Identification of the Financial Institution :

Part C provides specific fields for you to capture your direct deposit account information. Please check off () the box that represents the appropriate account type which the electronic payment is to be directed. In Australia there are a number of account types supported by the Government Foreign Payments Service provider. They include a bank account, postal account, building society account or a Bank Information Code (BIC). Please contact your local financial institution to obtain a better understanding of each account type.

[Long description of Part C Image - Identification of the Financial Institution]

Step 1 :

Must be completed by the financial institution or post office where you want your money deposited.

Step 2 :

Check off the box () that represents the appropriate account type.

Step 3 :

Enter the name(s) of the account holder(s).

Step 4 :

Enter your financial institution name and address.

Step 5 :

Please obtain the signature of the financial institution official.

Step 6 :

Enter your bank area code and telephone number, in the event that they need to be contacted for clarification on the information provided.

Step 7 :

The beneficiary must sign and date the bottom of the enrollment form. If the individual completing this form is a guardian or a relative acting on behalf of the beneficiary, this enrollment information will not be considered valid without the beneficiary's signature.

Note

For additional information, call 1 800 041 432 between the hours of 8 a.m. and 8 p.m., Eastern time.

Provision of the information requested on this form is required to effect direct deposit payments. This personal information will be stored in Personal Information Bank Number PWGSC PPU 085 and is protected under the Privacy Act. Under the Act you have the right to request access to and request correction if erroneous or incomplete. The information is retained for six years after the last administrative action and then destroyed.