AGE UK EXETER DIRECT DEBIT FORM THANK YOU FOR

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AGE UK EXETER CONTROLLED DOCUMENT DOCUMENT NAME
AGE UK EXETER DIRECT DEBIT FORM THANK YOU FOR

Age UK Exeter Direct Debit Form

Thank you for making a regular donation to Age UK Exeter. Your generosity is greatly appreciated.

In order to set up a Direct Debit please complete both pages of this form and return it to us in the freepost envelope enclosed.

Name:
Address:
Post Code:
Amount:	£
Frequency:	Weekly / Monthly / Yearly (delete as required)

Once you have completed the details above, please continue to complete the Instruction to your bank or building society to pay by Direct Debit form over the page.

Age UK Exeter

Instruction to your
bank or building society
to pay by Direct Debit

Please fill in the whole form including official use box using a ball point pen and send it to:

Service User Number

Age UK Exeter

138 Cowick Street

Exeter

EX4 1HS

FOR PSL re Age UK Exeter OFFICIAL USE ONLY

This is not part of the instruction to your Bank or Building Society.

Important – Please complete these details:

Account Holder(s) Name & Address:

Name:

Address:

Postcode:

Email Address:

Name(s) of Account Holder(s)

Bank/Building Society account number

Branch Sort Code

Instruction to your bank or building society

Please pay PSL re Age UK Exeter Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with PSL re Age UK Exeter and, if so, details will be passed electronically to my bank/building society.

Name and full postal address of your Bank or Building Society

To: The Manager

Bank/Building Society

Address

Signature(s)

Postcode

Date

Reference

Banks and Building Societies may not accept Direct Debit Instructions for some types of account

DDI1

T AGE UK EXETER DIRECT DEBIT FORM THANK YOU FOR his guarantee should be detached and retained by the Payer.

AGE UK EXETER DIRECT DEBIT FORM THANK YOU FOR The

Direct Debit

Guarantee

This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.

If there are any changes to the amount, date or frequency of your Direct Debit PSL re Age UK Exeter will notify you 3 working days in advance of your account being debited or as otherwise agreed. If you request PSL re Age UK Exeter to collect a payment, confirmation of the amount and date will be given to you at the time of the request.

If an error is made in the payment of your Direct Debit, by PSL re Age UK Exeter or your bank or building Society, you are entitled to a full and immediate refund of the amount paid from your bank or building society

- If you receive a refund you are not entitled to, you must pay it back when PSL re Age UK Exeter asks you to

You can cancel a Direct Debit at any time by simply contacting your bank or building Society. Written confirmation may be required. Please also notify us.

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