Authority to Accept Direct Debits

Not to operate as an assignment or agreement.

Complete the fields below or alternatively download the Authority to Accept Direct Debit form. Please freephone 0800 10 22 76 with any enquiries.

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Account Details

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Level of account authority

Bank Details

Formatted XX – XXXX – XXXXXXX – XXX

Payment Details

Maximum 12 characters

Maximum 12 characters

Maximum 12 characters


1. The initiator:
a. has agreed to send notice of the net amount of each direct debit no later than the day the direct debit is initiated. this notice will be provided in writing (including by electronic means and sms where the customer has provided prior written consent (including by electronic means and sms) to communicate electronically). the notice will include the following message: “the amount of $........ was direct debited to your bank account on (initiating date).”
b. may, upon the relationship which gave rise to this authority being terminated, give notice to the bank that no further direct debits are to be initiated under the authority. upon receipt of such notice the bank may terminate this authority as to future payments by notice in writing to me/us.

2. The customer may:
a. at any time, terminate this authority as to future payments by giving notice of termination to the bank and to the initiator by means agreed by the customer, bank and initiator.
b. stop payment of any direct debit to be initiated under this authority by the initiator by giving written notice to the bank prior to the direct debit being paid by the bank.
c. where a variation to the amount agreed between the initiator and the customer from time to time to be direct debited has been made without notice being given in terms of clause 1a above, request the bank to reserve or alter any such direct debit initiated by the initiator by debiting the amount of the reversal or alteration of a direct debit back to the initiator through the initiator’s bank provided such request is made not more than 120 days from the date when the direct debit was debited to my/our account.

d. Request the Bank to reverse any Direct Debits initiated by the Initiator under the Instructions by debiting the amount of the Direct Debits back to the Initiator through the Initiator’s Bank where the Initiator cannot produce a copy of the Instructions and/or Confirmation to me/us that I/we are reasonably satisfied demonstrate that I/we have authorised my/our bank to accept Direct Debits from the Initiator against my/our account PROVIDED the request is made not more than 9 months from the date when the first Direct Debit was debited to my/our account by the Initiator under the Instructions.

3. The customer acknowledges that:
a. this authority will remain in full force and effect in respect of all direct debits passed to my/our account in good faith notwithstanding my/our death, bankruptcy or other revocation of this authority until actual notice of such event is received by the bank.
b. in any event this authority is subject to any arrangement now or hereafter existing between me/us and the bank in relation to my/our account.
c. any dispute as to the correctness or validity of an amount debited to my/our account shall not be the concern of the bank except in so far as the direct debit has not been paid in accordance with this authority. any other dispute lies between me/us and the initiator.
d. where the bank has used reasonable care and skill in acting in accordance with this authority, the bank accepts no responsibility or liability in respect of
i. the accuracy of information about direct debits on bank statements; and
ii. any variations between notices given by the initiator and the amounts of direct debits.
e. the bank is not responsible for, or under any liability in respect of the initiator’s failure to give notice in accordance with clause 1a nor for the non receipt or late receipt of notice by me/us for any reason whatsoever. in any such situation the dispute lies between me/us and the initiator.

4. The bank may:
a. in its absolute discretion conclusively determine the order of priority of payment by it of any monies pursuant to this or any other authority, cheque or draft properly signed by me/us and given to or drawn on the bank.
b. at any time terminate this authority as to future payments by notice in writing to me/us.
c. charge its current fees for this service in force from time to time.