Secure Form

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Direct Payment
Required
Bank A/C Details

ASB BANK 12 3151 0093789 000
A/C Name - NZSERVERS
Swift Code - ASBBNZ2A

WESTPAC

03 1704 0047290 000
A/C Name - NZSERVERS LTD
Swift Code - WPANCNZ2W

Once you have transfered the funds it would be helpful for our records if you complete this form
The funds transfered must be clear of any bank admin fees
Form Type
Company Name
First Name
Last Name
Email Address
Verify Email Address
Telephone (home)
Telephone (Business)
Country
DIRECT PAYMENT DETAILS
Date Paid
Bank A/C used

ASB Bank Westpac

Type of Payment

Domain Fees Other

Domain Name
Reference:- If you are paying an Invoice enter the invoice no as the reference. If you are paying more than one invoice enter the invoice Numbers followed by a comma. If you are paying a statement balance then enter "Balance" as the reference.
Reference used
Value Paid
     
General Comments

Verification Code

[Numbers are from 2 to 9] All letters are uppercase

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