SEPA Direct Debit Mandate Form
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ScribdTranslationsSEPA Direct Debit Mandate Form
Translated by
ScribdTranslationsSEPA Direct Debit Mandate
SEPA Direct Debit Mandate
Directout
To be filled debit
by mandate reference
the creditor
To be completed by the creditor
Identicador del acreedor /Creditor´s identier
Nombre del acreedor /Creditor´s name
Address
Código Postal – Población – Provincia /Postal Code – City – Town
País /Country
By signing this direct debit order, the debtor authorizes (A) the creditor to send instructions to the debtor's entity to debit from
your account and (B) to the entity to make deductions from your account following the creditor's instructions. As part of their rights, the debtor
it is entitled to a refund by its entity in the t rminos y condiciones del contrato suscrito con la misma. La solicitud de reembolso deberá
to be carried out within the eight weeks following the date of the debit on your account, You can obtain additional information about your rights in your
financial entity.
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 your account was debited.
Your rights are explained in a statement that you can obtain from your bank.
Debtor's name
Dirección del deudor /Address of the debtor
Código Postal – Población – Provincia /Postal Code – City – Town
Country of the debtor
SwitBIC / SwitBIC (can contain 8 or 11 characters) / SwitBIC (up to 8 or 11 characters)
Account number – IBAN
Tipo de pago: Recurrent payment One-off payment
Fecha – Localidad /Date – locaton in wich you are signing
Signature of the debtor
ALL FIELDS MUST BE FILLED IN MANDATORILY. ONCE SIGNED, THIS ORDER
THE DIRECT DEBIT MUST BE SENT TO THE CREDITOR FOR SAFEKEEPING. / ALL GAPS ARE MANDATORY. ONCE THIS
MANDATE HAS BEEN SIGNED, MUST BE SENT TO CREDITOR FOR STORAGE.