SEPA Direct Debit Mandate
Name of Creditor: UPC Communications Ireland Limited
To be completed by UPC/ For Office Use Only
Unique Mandate Reference (UMR): ______________________
Address of Creditor: SME Department, Building P2, Eastpoint Business Park, Clontarf, Dublin 3
T: 353 (0)1800-941-941 F: 353 (0)1-245-8515 E: sme@upc.ie / b2b-iesupport@upc.ie
Creditor
Identifier: IE42SDD992847
UPC
Communications
Ireland Limited
By signing this mandate form, you authorise UPC to send instructions to your bank to debit your account and your bank to debit your
account in accordance with the instruction from UPC. As part of your rights, you are entitled to a refund from your bank under the terms
and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account
was debited. Your rights are explained in a statement that you can obtain from your bank.
Please complete all fields marked *
Bank Account to be debited:
Type of Payment:
Recurrent
*Swift BIC: _________________________
*IBAN/ Account No: ___________________________________
*1st Customer Name: __________________________________
Customer Address: __________________________________
2nd Customer Name: ___________________________________
____________________________________________________
*Signature 1: __________________________________________
Signature 2: __________________________________________
*Date: _ _ /_ _ /_ _
Date: _ _ /_ _ /_ _
Please complete and return this mandate to UPC (the Creditor)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------For Information Purposes Only
UPC Customer Account Number: _____________________
Customer Contact number : ___________________________
The amounts are variable and may be debited on various dates in accordance with your billing frequency. A mandate is required for foreign bank