Direct Debit Application

Please ensure that data is entered correctly

Would you like to set up your Direct Debit Instruction now? I will need your bank details and your name and address.

Payer agrees.

All I need are your bank details.

Are you the account holder and the only person required to authorise direct debits from this account?

Read more If two or more people are required by the bank to authorise new Direct Debits, this form cannot be used. Please contact Charterhouse Voice & Data Limited to discuss alternatives.

If 'Yes', tick the box and continue. If 'No', send a paper Direct Debit Instruction.

What is the account name?

What is the account number?

What is the bank sort code?

This will be on your bank statement or on your cheque book.

Bank account information

Name of account holder(s) Please enter a valid bank account name

Sort code

Account number

If the payer is not sure of their details, issue a paper Direct Debit Instruction. Enter the details and we will verify that payments by debits can be made from this bank/account.

Could I take your contact details please?

Title

First name Please enter a first name

Last name Please enter a last name

Email address Please enter an email

Mobile phone number

Current address

I am applying on behalf of a company

If business confirm that this person is authorised to allow debit payments. If not, issue a paper Direct Debit Instruction.

Company name

Company registration no.

Postcode Please enter a post code

Building number or name Please enter a building name or number

Address Please enter address

Town or city

References

Please note the plan reference should be easily identifiable.

Plan reference Please enter a valid DD plan reference

Alt. reference Please enter a valid DD plan alt. reference

Plan Type

Ad Hoc

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, Charterhouse Voice & Data Limited will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Charterhouse Voice & Data Limited 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 Charterhouse Voice & Data 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 society.
- If you receive a refund you are not entitled to, you must pay it back when Charterhouse Voice & Data Limited asks you to.
You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

The details of your Direct Debit Instruction will be confirmed to you within 3 working days or no later than 10 working days before the first collection.

Charterhouse Voice & Data Limited will appear against the Direct Debit on your bank statement.

Let me confirm your account details back to you.

The account name is xxxxxxxxxxx.
The account number is xxxxxxxx.
The sort code is xxxxxx.

Confirm that the above Bank Account information is correct.

If details are confirmed, the Direct Debit Instruction is complete.

Your payments are protected by the Direct Debit Guarantee.