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Indemnify Tier One

Completing the application form below allows Assure Global Plus act on your behalf for the recovery of your client's outstanding debts

Company/Business Details

Bank Account Details

Bank account details are required for recoveries payments to the company's business account. While not mandatory for the application, the business bank account details will be required for payments to the business once we commence recoveries activity.
Please enter your business bank account name
Please enter your business's bank name and Branch (e.g. Westpac, George Street Parramatta Branch)
Please enter your bank's Business Service Branch (BSB) number
Please enter your business's bank account number

Agreement

The Agent adheres to the Privacy Act 1988 (As amended) and the Australian Privacy Principles. Any information collected will be used only for the purpose for which it is collected, unless otherwise authorised by the client.
I hereby authorise Assure Global Plus (NCI Group Australia Pty Ltd T/as) to act on our behalf for the collection of accounts and in the matters relating to all collections and legal action deemed necessary as instructed to recover monies due and owing.