From:
S241
To:
Accounts Receivable
Subject:
S241 Application Payment
Date:
Monday, 11 April 2022 5:54:00 pm
Attachments:
image001.png
Auror DD Authority.pdf
Hi there
Can you please process a direct debit payment of $854.57 for the following S241 applicant, their
DD form is attached:
Auror Limited
NZBN: 9429030695603
ACT 1982
Company # 3792596
s 9(2)(a)
s 9(2)(a)
@auror.co
Thanks very much
Kind regards
Gemma Rush (she/her)
INFORMATION
Senior Case Officer, Exemptions & Registers Integrity
Te Roopu Waeture | Regulatory Services
Waka Kotahi NZ Transport Agency
Palmerston North
Private Bag 11777, Palmerston North 4442, New Zealand
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RELEASED UNDER THE OFFICIAL

NZTA CUSTOMER NO:_____________________
IMPORTANT!
PLEASE ENCLOSE BANK DEPOSIT SLIP FOR
ACCOUNT VERIFICATION AND RETURN TO THE
NZ TRANSPORT AGENCY
ACCOUNT INFORMATION
Name of Account
AUTHORITY TO ACCEPT
Customer (Acceptor) to complete bank/branch number and account number
DIRECT DEBITS
and suffix of account to be debited.
(not to operate as an assignment or agreement)
s 9(2)(a)
ACT 1982
Bank
Branch Number
Account Number
Suffix
Authorisation Code s 9(2)(a)
(User Number)
TO: The Manager
Bank Name
s 9(2)(a)
Address (PO Box)
Town/City
Date
DD
/
MM
/ YYYY
INFORMATION
I/We authorise you until further notice in writing to debit my/our account with you all amounts which -
NEW ZEALAND TRANSPORT AGENCY
(hereinafter referred to as the Initiator)
the registered Initiator of the above Authorisation Code, may initiate by Direct Debit.
I/We acknowledge and accept that the bank accepts this authority only upon the conditions listed on the reverse of this form.
INFORMATION TO APPEAR ON MY/OUR BANK STATEMENT
Payer Particulars
Payer Code
Payer Reference
Name of Account (Customer to complete)
Authorised Signatures
s 9(2)(a)
FOR BANK USE ONLY
Date Received
Recorded By
Checked By
APPROVED
RELEASED UNDER THE OFFICIAL
BANK
0510
STAMP
10/10
Original
- Retain at Branch
Copy
- Forward to Initiator if requested

Document Outline