Tick one box to show the frequency you want to pay:
(pay in full each bill) Half yearly
Monthly (12 months)
Please tell us which date of the month you
would like us to collect your payment. We
will collect on that date or within three
working days after that date.
For four-weekly, fortnightly and weekly please
select which workday to take your payment.
Number of occupants in your property
This information is only required to
if you are already a customer of United Utilities you will ﬁnd this number on a recent water bill.
estimate your water use and calculate the
Please also include this number in the ‘Reference’ box shown on the Direct Debit instruction below.
The information in this section will be treated as conﬁdential and will be detached before the instruction below is sent to your Bank or Building Society - Thank you.
Instruction to your Bank or Building Society to pay by Direct Debit
Please complete this form and return to:
United Utilities, PO Box 451, Warrington WA5 3QH
1 Name and full postal address of your Bank or Building Society
To the Manager
Bank or Building Society
2 Name(s) of account holder(s)
3 Bank/Building Society account number
4 Branch sort code
Service user number
7 6 8 3 6 5
6 Instruction to your Bank or Building Society
Please pay United Utilities Water Limited 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 United
Utilities Water Limited and, if so, details will be passed
electronically to my Bank or Building Society.
Banks and Building Societies may not accept Direct Debit instructions for some types of account.
This guarantee should be detached and retained by the payer
The Direct Debit Guarantee
• This guarantee is offered by all banks and building societies that accept
• If an error is made in the payment of your Direct Debit, by United Utilities
instructions to pay by Direct Debits.
Water Limited or your bank or building society, you are entitled to a full
and immediate refund of the amount paid from your bank or building
• If there are any changes to the amount, date or frequency of your Direct
Debit, United Utilities Water Limited will notify you 10 working days in
advance of your account being debited or as otherwise agreed. If you
• If you receive a refund your are not entitled to, you must pay it back when
request United Utilities Water Limited to collect a payment, conﬁrmation
United Utilities Water Limited asks you to.
of the amount and date will be given to you at the time of the request.
• You can cancel a Direct Debit at any time by simply contacting your bank
or building society. Written conﬁrmation may be required. Please also