Fill this online form to authorise ClickPOS accounts department to charge the monthly fees directly from your nominated account.
Please ensure there are cleared funds available on first working day of each month.
You will receive an invoice sent to your nominated email after the processing is complete.
You may opt to fill a PDF version of the form please
click here to download
, fill the form, scan or take a photo then email to
Accounts@ClickPOS.com
Credit Card Or Direct Debit Authority (CCDA)
Enter Your Details
Company Name
ClickPOS Login
Contact Name
Telephone Number
Email
Enter Authority Details
Direct Debit Authority
Credit Card Authority
Fill this section if you want to make payments using your bank account eg Cheque or Savings.
(for Accounts held in Australia only)
I/We request CLICKPOS PTY LTD to arrange for funds to be debited from my/our nominated account.
Financial Institution
Account Name
Account Number
BSB Number
Do you have a second account holder for this account?
Fill this section if you want to make Payment using your CREDIT CARD
I request CLICKPOS PTY LTD to arrange for funds to be debited from my nominated credit card.
NOTE: Payments by credit card will incur a card surcharge fee of 1.5%
Card Type
Visa
Master Card
Bank Card
Card Number
Card Expiry Month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Card Expiry Year
2023
2024
2025
2026
2027
2028
2029
Card Holder Name
Please Sign Below (with Mouse or Touchscreen)
Secondary Account Holder - Please Sign Below (with Mouse or Touchscreen)
Reset
You can click button below to email it directly to
accounts@clickpos.com
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Or you can click link below to download, validate & email signed document to
accounts@clickpos.com
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Please note that file will be deleted once you close this window