Set up a direct debit

Details

*This is a mandatory field. What are you setting up a Direct Debit for?

*This is a mandatory field. allpay Payment Reference Number

*This is a mandatory field. First Name

*This is a mandatory field. Last Name

*This is a mandatory field. E-mail

Phone Number

Address details

*This is a mandatory field. House Number and Street Name

Building Name/Flat Number

*This is a mandatory field. Town or City

County

*This is a mandatory field. Postcode

Payment Details

*This is a mandatory field. Initial Direct Debit Amount

*This is a mandatory field. Ongoing Direct Debit Amount

*This is a mandatory field. Frequency

Ongoing Payment Date

*This is a mandatory field. Initial Payment Date

*This is a mandatory field. Ongoing Payment Date

Step 1 of 3

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