Hodge
One Central Square
Cardiff
CF10 1FS
Please fill in this form and send it to us on online or to:
Instructions to your bank
or building society to pay
by direct debit
Names(s) of account holder(s)
Bank/building society account number
Branch sort code
Name and full postal address of your bank or
building society
Address
Postcode
Service user number
Reference
Instructions to your bank or
building society
Please pay Hodge 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 Hodge and,
if so, details will be passed electronically to my
bank/building society.
Signature(s)
Date
The Direct Debit Guarantee
• This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
• If there are any changes to the amount, date or frequency of your Direct Debit Hodge will notify you 10
working days in advance of your account being debited or as otherwise agreed. If you request Hodge to
collect a payment, confirmation of the amount and date will be given to you at the time of the request
• If an error is made in the payment of your Direct Debit, by Hodge or your bank or building society you are
entitled to a full and immediate refund of the amount paid from your bank or building society
• If you receive a refund you are not entitled to, you must pay it back when Hodge asks you too
• You can cancel a Direct Debit at any time simply by contacting your bank or building society.
Written confirmation may be required. Please also notify us.
To: The Manager
Bank/building society
8 4 0 4 4 7
click to sign
signature
click to edit
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click to sign
signature
click to edit
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