Direct Debit

Credit Application and Additional Information

Direct Debit

Company Details

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Bank account details

For more than 2 signatories, please complete this form and upload it (note: signatories need to be pen-signed):

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Maximum file size: 100MB

Please provide 15 digital account number

Conditions of this authority to accept direct debits

  1. I agree that the Initiator must give me at least 10 days’ prior notice of each direct debit, including the first direct debit in a series.
  2. Changes to the amounts or dates of a series of direct debits require 3 days’ prior notice to me.
  3. I can also agree with the Initiator to receive a same day notice for direct debits specifically requested by me.
  4. All notices must be in writing, but can be delivered electronically, if I have agreed that with the Initiator.
  5. I can also ask you to reverse a direct debit up to 120 days after the direct debit if:
    • I didn’t receive proper notice of the amount and date of the direct debit, or
    • I received notice but the amount or date of the direct debit is different from the amount or date on the notice.
  6. If I dishonour a direct debit but the Initiator retries it within 5 business days of the original direct debit, I understand that the Initiator doesn’t need to notify me again about that direct debit.


By submitting this form I/we authorise you, until further notice, to debit funds from my/our account at the financial institution named above and acknowledge that the bank accepts this authority on the conditions listed on the bottom of this form.

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