Commonwealth Consolidated Regulations

[Index] [Table] [Search] [Search this Regulation] [Notes] [Noteup] [Previous] [Download] [Help]

NATIONAL CONSUMER CREDIT PROTECTION REGULATIONS 2010 - SCHEDULE 10

Employer authorisation--prescribed form of statement

Note:   See subregulation   28LCE(2).

 

[Form]   Consent to make direct deductions from salary or wages

Subsection   160E(2) of the Act

[Regulation   28LCE of the Regulations]

TO:       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(name of employer of debtor/lessee)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(address of employer of debtor/lessee)

FROM:     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(name of credit provider/lessor)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(Australian credit licence number)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(address of credit provider/lessor)

Complete all of the following information (except as indicated) before signing the form

Date of first deduction:

Date of last deduction:

Amount of each deduction:

IMPORTANT

YOU CAN CANCEL THIS DEDUCTION REQUEST DIRECTLY WITH YOUR EMPLOYER AT ANY TIME.

IF YOU CANCEL THIS DEDUCTION REQUEST YOU WILL BE IN DEFAULT IF YOU DO NOT MAKE ALTERNATIVE ARRANGEMENTS TO MAKE REPAYMENTS.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(signature of debtor/lessee giving consent)

I confirm I have been provided with a copy of this form.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(signature of debtor/lessee giving consent)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date of signing

The following information is optional

INFORMATION TO THE EMPLOYER

These arrangements relate to a contract between your employee and a third party. You are not liable for any failure of your employee to make payments to that person.

Your employee may ask you to cancel these arrangements at any time or may vary them by completing a new form.

 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(signature of employer)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date of signing


AustLII: Copyright Policy | Disclaimers | Privacy Policy | Feedback