Application for your cloud payment solution

To be completed by the Business Owner or Director

Fields marked with * are required

To submit your application, you will need your Driver’s Licence and ABN.

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Business Owner or Director
Contact Details
Organisation Details
Your Business Address

Please provide a physical address or PO Box.

Type of Business
Ezidebit Fees


Fee Type Fee (incl GST)
Customer Setup Fee $5.50
Bank Account $1.65
Visa/MasterCard 2.20%
Amex/Diners 4.40%
Payment Reminder SMS notification $0.15

You can design the best fee structure for your business. Please select your fee allocation before proceeding

A $1.65 fee will be applied for each settlement transaction deposited to your account.

Please note a minimum monthly fee of $19.90 may be charged. Maximum single transaction limits apply.

Bank Account Number

Where would you like us to deposit your revenue?


We require your driver's licence, 18+ card or other state issued photo ID and home address to confirm your identity before settling funds to your account.

Supplementary Document

Please upload a copy of an official bank document (this can include a screenshot of your internet banking screen) which shows the full account name and number.

Please upload a copy of photo ID such as driver's licence or passport.


By completing and submitting this Ezidebit application form, You acknowledge:

  • You are the business owner or Director of your Company
  • You have read and considered the Financial Services Guide and Product Disclosure Statement and you agree to be bound by Ezidebit’s Terms and Conditions
  • You agree to have your credit history checked by a third party;
  • Agree to provide documentation to establish your identity as part of the application process; and
  • You certify that the information provided regarding your business activities is true and complete

To opt out of receiving marketing information or if you have any questions please give us a call on 1300 763 256.