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Otherwise simply fill in the details below in black ink, cut along the dotted line and return the
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Instruction to your Bank or
Building Society to pay by Direct Debit
Please fill in the whole form using a ball point pen and send to: East Lindsey District Council,
The Credit Control Team, P.O. Box 20, Manby Park, Louth, Lincolnshire LN11 8XN
Name and full postal address of your Bank or Building Society
Service User Number
Banks and Building Societies may not accept Direct Debit instructions for some types of account.
To: The Manager Bank/Building Society
Address
Postcode
Instruction to your Bank or Building Society
Please pay East Lindsey District Council Direct Debits
from the account detailed in this instruction subject to
the safeguards assured by the Direct Debit Guarantee. I
understand that this instruction may remain with East
Lindsey District Council and, if so, details will be passed
electronically to my Bank/Building Society.
Signature(s)
Date
Name(s) of Account Holder(s)
Branch Sort Code
Bank/Building Society Account Number
441087
Reference (CEL)