Get Au Iman Direct Debit Request & Claims Benefit Form 2013

This guide provides comprehensive instructions on how to complete the AU IMAN Direct Debit Request & Claims Benefit Form online. It aims to assist users in accurately filling out the necessary sections to ensure a smooth submission process.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to access the form and open it for editing.
2. Enter your policy number if you have it. This helps IMAN identify your account.
3. Provide your last name and first name. Ensure the names are entered exactly as they are registered with IMAN.
4. Fill in your phone number and mobile number. This is important for any communications related to your account.
5. Select your preferred payment frequency from the available options: Fortnightly, Monthly, Quarterly, Yearly, or Half Yearly. Only choose one payment method.
6. Indicate your preferred date to commence the payment. Format it as day/month/year.
7. In the Direct Debit Request section, write your full name or your business name. This ensures the payment is associated with the correct account.
8. Enter the name of your bank, building society, or credit union, and the branch location.
9. Provide the details of the account holder(s), including BSB number and account number. Double-check these details for accuracy.
10. Sign and date the form where indicated. If there are multiple account holders, ensure all necessary signatures are included.
11. If you are opting for Credit Card Authority, fill in the card type, cardholder's name, card number, and expiry date.
12. Verify all the information you've entered to ensure accuracy.
13. Once you have completed the form, save any changes you made. You can also download, print, or share the form as needed.

Complete your AU IMAN Direct Debit Request & Claims Benefit Form online today to ensure your health coverage is managed efficiently.