customer details

Direct Debit Guarantee

The 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 the organisation will notify you (normally 10 working days) in advance of your account being debited or as otherwise agreed. If you request the organisation 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 the organisation 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 the organisation 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 the organisation.

We are Data Secured by the Wix General Data Protection Regulation,
We are confident and ensure that all personal information given to Appliance Safe Ltd will not be used for any other service than our own, and if contacted by yourself after this process has been submitted, wanting the information you provided deleted from our system is an option.

As our payments are processed by GoCardless, for any information you may require, please head over to our processors website >> Privacy Centre <<

First Name

Last Name

Phone

Date Of Birth

Property Number

Flat Number

Street

Town

County

Post Code

Direct Debit

Authorisation to set up Direct Debit payments

Requires 1 Signature

Requires 2 Signatures

First Name of Second Occupant

Second Name of Second Occupant

Is the second required signature living at the same address as the first?

Yes

If not, Please state their address here?

Payment Details

Name as appears on card

Account Number

Sort Code

Your Signature

Second Signature If Required

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