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 Direct Debit Form


Please ensure your instalments are paid up to date before completing the Direct Debit Form.

Any completed forms received before the 15th of the month will be set up for the following monthly instalment. A revised bill will be sent to confirm this.

Any completed forms received after the 15th of the month may not be processed until the following month, therefore please pay the next instalment by an alternative payment method.

Your payment will be taken on the 1st of the month (or the 1st working day if the 1st falls on a non working day)


Title                 

Full Name        

Address  for correspondence        

Postcode in CAPITALS eg: DY10 1FB    

Daytime telephone/mobile number     

Email Address   

Do you wish to receive your bills by email?
Does the Label  bill relate to the address above

                      
Direct Debit Mandate
Instruction to your Bank or Building Society to pay by Direct Debit

Name(s) of account holder as it appears on the account

  



Name of Bank or Building Society


Address of Bank



Bank or building society account number
         

Branch Sort Code
   

   Reference Number
 

Instructions to your bank or building society:

Please pay Wyre Forest District Council Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit guarantee.
  I/We understand that this instruction may remain with Wyre Forest District Council and, if so details will be passed electronically to my/our bank or building society

Banks and building societies may not accept Direct Debit instructions for some type of accounts.

I/We understand applications for Directs Debits received prior to the 15th of the month will be in place for the next monthly instalment. Applications received after the 15th may not be processed until the following month.

Read the Direct Debit Guarantee


WYRE FOREST DICTRICT COUNCIL IS UNDER A DUTY TO PROTECT THE PUBLIC FUNDS IT ADMINSTERS AND THEREFORE MAY USE THE INFORMATION YOU HAVE PROVIDED ON THIS FORM FOR THE PREVENTION AND DETECTION OF FRAUD. IT MAY ALSO SHARE THIS INFORMATION WITH OTHER BODIES RESPONSIBLE FOR AUDITING OR ADMINISTRATING PUBLIC FUNDS FOR THESE PURPOSES. FURTHER INFORMATION IS AVAILBLE ON OUR WEBSITE. INISTRATING PUBLIC FUNDS FOR THESE PURPOSES.

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