Direct Debit Service Agreement
I/WE, authorise The Health and Community Services Union (HSU Vic No. 2 Branch) Direct Debit User No.017325 to arrange for funds to be debited from my/our account of the financial institution identified below and as prescribed below through the Bulk Electronic Clearing System (BECS). These drawings are for union membership dues as determined by the Branch Committee of Management. This authorisation is to remain in force until further notice.
I/WE authorise the following:
The Debit User to verify the details of the account with my/our Financial Institution.
The Financial Institution to release information allowing the Debit User to verify the account details.
Account details to be finalised over the phone directly with HACSU.
Declaration - Civil Liability Professional Indemnity Insurance
I, being a financial member of the Health and Community Services Union (Health Services Union Victoria No.2 Branch), hereby give notice that I appoint the said union as my agent for the purposes of giving and accepting of notices in respect of Civil Liability Professional Indemnity Insurance in accordance with the Insurance Contracts Act 1984 and its Regulations. I also undertake to report any facts or circumstances, which might give, rise to a claim under the policy to the said Union as soon as I become aware of any facts or circumstances.