Department of Foreign Affairs and Trade
Please cross out whichever is not applicable:
• Payment of Charges: Deposit / In Full
• Payment by: Credit Card / Direct Debit / Cheque or Money Order
For the sum of $_______________ as detailed in the FOI Estimate of Charges letter dated
__________________ (FOI Ref: LEX2125)
Credit Card
Name
_________________________________
Address
_________________________________
_________________________________
_________________________________
I authorise the National Cashier of the Department of Foreign Affairs and Trade to debit my
VISA
MASTER CARD
--- Expiry: _____/_____
Name appearing on card: _________________________
Signature: _____________________________________
Direct Debit
Account Name:
Department of Foreign Affairs and Trade
BSB No.:
092-009
Account No.:
110329
Please include your surname and FOI Ref: LEX2125 in the reference field.
Cheque/Money Order
Make payable to: ‘The National Cashier – DFAT’
Send to:
Director, FOI Section
Department of Foreign Affairs and Trade
R. G. Casey Building
John McEwen Crescent
Barton ACT 0221
R G Casey Building John McEwen Cres Barton 0221
DFAT.GOV.AU
T
+61 2 6261 1111
@DFAT