Sepa Direct Debit Mandate

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Basic Details

Contact Name *

Contact Name

First Name

Last Name

Charity Name *

Email Address *

The person who will be sent the a monthly invoice and receipt of payment

Payment Details

BIC

IBAN of the bank account that will be debited each month

IBAN

IBAN of the bank account that will be debited each month

Bank Account *

Can this bank account accept Direct Debits?

Yes

No

Permission *

Is there more than one signatory required to sign on your account?

Yes

No

Address Details

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Promo Code

LEGAL INFO

LIKECHARITY
23 William St. South
Dublin 2
+353 1 557 2425

Creditors Identifier No. IE41SDD361298

By signing this mandate form, you authorise (A) Payimo to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instruction from Payimo.

As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which you account was debited. Your rights are explained in a statement that you can obtain from your bank.