This section is about your method of payment for your lifestyle insurance. Please select either Credit Card or Direct Debit as your payment option. Only complete the section for the option you have chosen.
Card type: Please make a selection from the drop down list.
Card number: This is your credit card number.
Expiry date: Please select the month, then the year, that your credit card will expire from the appropriate drop down list.
Cardholder's name: This is the name of the card holder.
Name(s): This is the name(s) of the account holder(s).
Account name: This is the name of the account.
Name and branch of financial institution: Enter the name and branch of the financial institution.
Address of financial institution: Enter the address of the financial institution.
BSB Number: This is the BSB (Bank, State, Branch) number of your financial institution.
Account Number: Enter the account number.