UPC Communications Ireland Limited
Building P2,
Eastpoint Business Park,
Clontarf,
Dublin 3.
Telephone 1800 924924
Fax + 353 (0)1 2458515
Email upcbusiness@upc.ie
Direct Debit Mandate
UPC Origination Number: 992847
When Completed, Please return this form to: SME Department, UPC Communications Ireland Limited, Building P2,
Eastpoint Business Park, Clontarf, Dublin 3
UPC Customer Number
Subscribers: Bank:
Bank Account Number
Sort Code
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Account Holders name
I/We instruct you to pay Directs Debit from my account at the request of UPC. The amounts are variable and may be debited
on various dates in accordance with my billing frequency. I understand that if a Direct Debit paid which breaks this instruction,
the Bank will make a refund.
This mandate cancels all previous Standing Orders/Mandates in favour of UPC Communications Ireland Limited under the
reference quoted above.
Signatures (s)
Date
This is a guarantee provided by your own Bank as a member of the Direct Debit Scheme, in which Banks and Originators of Direct Debits participate.
• If you authorize payment by Direct Debit:
- Your direct Debit Originator will notify you in advance of the amounts to be debited to your account.
- Your Bank will accept and pay such debits, provided that your account has sufficient available funds.
• If it is established that an unauthorized Direct Debit was charged to your account, you are guaranteed an immediate refund by your Bank of the amount so
charged where you notify you bank without undue delay on becoming aware of the unauthorized Direct Debit, and in any event no later than 13 months after
the date of debiting of such Direct Debit to your account.
• You are entitled to request a refund of any variable Direct Debit which exceeded the amount which you could reasonably have expected, subject to you so
requesting your bank within a period of 8 weeks from the date of debiting such Direct debit to your account; your bank is entitled to ask you to provide factual
elements relating to your request for a refund.
• You can request your bank to refuse a Direct Debit payment on your account up to close of business the day before the Direct
Banks may refuse to accept instructions to pay direct debit from some types of accounts. UPCFD 006 REVO