Orden de domiciliación de adeudo directo SEPA

SEPA Direct Debit Mandate

Referencia de la orden de domiciliación: 30057557-1
Mandate reference
A cumplimentar por el acreedor

Identificador del acreedor: ES96014B86458643

To by comlpeted by the creditor

Creditor identifier

Nombre del acreedor: Siresa Campus S.L.

Creditor’s name

Dirección: Calle Serrano 41

Address

Código Postal - Población: 28001 Madrid

Postal Code – City – Town

País: Spain
Country
Mediante la firma de esta orden de domiciliación, el deudor autoriza (A) al acreedor a enviar instrucciones a la entidad del
deudor para adeudar su cuenta y (B) a la entidad para efectuar los adeudos en su cuenta siguiendo las instrucciones del
acreedor. Como parte de sus derechos, el deudor está legitimado al reembolso por su entidad en los términos y condiciones
del contrato suscrito con la misma. La solicitud de reembolso deberá efectuarse dentro de las ocho semanas que siguen a la
fecha de adeudo en cuenta. Puede obtener información adicional sobre sus derechos en su entidad financiera.
By signing this mandate form, you authorise (A) the Creditor to send instructions to your bank to debit your account and (B) your bank to debit your
account in accordance with the instructions from the Creditor. 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 eight weeks starting from the date on which your account was debited. Your rights are explained in a
statement that you can obtain from your bank.
Nombre del deudor/es / Debtor’s name
(titular/es de la cuenta de cargo)
Mónica Monteiro Monteiro
Dirección del deudor / Address of the debtor
avenida torres do marco n115
Código Postal – Población – Provincia / Postal Code – City – Town
A cumplimentar por el deudor

4630-209 Marco de Canaveses

País del deudor /
O be completed by the debtor

Country of the debtor

Portugal
Swift BIC (puede contener 8 u 11 posiciones) / Swift BIC (up to 8 or 11 characters)
CGDIPTPLXXX
Número de cuenta – IBAN / Account number – IBAN
PT50003504380005076470029
En España el IBAN consta de 24 posiciones comenzando siempre por ES
Spanish IBAN of 24 positions always starting ES
Tipo de Pago: o
Pago recurrente or
Pago único
Type of payment X
Recurrent payment One-off payment

Fecha – Localidad: May 14, 2025

Date- location in which you are signing

Firma del deudor:

Signature of the debtor
TODOS LOS CAMPOS HAN DE SER CUMPLIMENTADOS OBLIGATORIAMENTE. UNA VEZ FIRMADA ESTA ORDEN
DE DOMICILIACION DEBE SER ENVIADA AL ACREEDOR PARA SU CUSTODIA
ALL GAPS ARE MANDATORY. ONE THIS MANDATE HAS BEEN SIGNED MUST BE SENT TO CREDITOR FOR STORAGE.
We inform you that SIRESA CAMPUS, S.L., with postal address at Calle Serrano 41 28001 Madrid and e-mail address privacy@[Link] will be
responsible for the data collected in this document. We will use the personal data to carry out the management and fulfilment of the relationship
established as a result of the contract made, such management includes, among others, the information and issuance of duplicate invoices and
monitoring of collections. The personal data will be communicated to other companies of the Resa group in order to comply with possible legal
obligations. The company may also transfer the data to bank(s) in order to allow direct debit of rent/monthly payments by the residents and/or the
persons responsible for payment, who may or may not coincide with the resident. Further information on the use of personal data has been
provided in the contract. Finally, we inform you that you have rights in relation to the processing of data, including the right to data portability,
access, rectification, erasure or restriction of data. We also inform you of your right to lodge a complaint with a data protection authority. You can
exercise the aforementioned rights by contacting us at privacy@[Link].