Isle of Wight Council

	Direct Debit Instructions for Business Rates
	To pay by Direct Debit please complete this instruction.
	Paying by Direct Debit gives you the following Benefits: * No more cheques to write * No need to spend time queuing to pay * We tell you in advance of the amounts and dates of payments * Your payments are protected by the Direct Debit guarantee * You can cancel the arrangement at any time giving you complete control * Three instalments are available on the 1st, 10th or 20th of each month If you have any questions contact the Business Rates helpline (01983) 823920. Please send the completed form to: Isle of Wight Council, Council Offices, Broadway, Sandown, Isle of Wight, PO36 9EA

	Instruction to your Bank or Building Society to pay Direct Debit
	Name(s) of Account Holder(s):

*	Bank/ Building Society account number (please enter single numbers in each box)
*	Branch sort code (please enter single numbers in each box)

Name and full postal address of your Bank or Building Society:

*	To the manager Bank/Building Society
*	Address
*	Postcode

	Reference number: (As shown on your Business Rates bill)
*

Originator's Identification Number

6

2

4

7

1

4

Please note: The following questions are for Isle of Wight Council purposes only - they are not part of the instructions to your Bank or Building Society.

*

Please indicate which instalment date you would like by ticking the appropriate box

1st 10th 20th

Name and address to which this information refers

*	Forename
	Middle name/Initials
*	Surname

*	Building/house name/number
*	Street address
*	Town name
	County
*	Postcode
	Email

*	To your Bank or Building Society Please pay the Isle of Wight Council Direct Debit from the account detailed in this instruction subject to the safeguard assured by the Direct Debit Guarantee. I understand that this instruction may remain with the Isle of Wight Council and if so details will be passed electronically to my Bank/Building Society. Signed............................................................... Name................................................................ Date..................................................................
	Banks and Building Societies may not accept Direct Debit Instructions for some types of account.

	THE DIRECT DEBIT GUARANTEE
	THIS GUARANTEE SHOULD BE DETACHED AND RETAINED BY THE PAYER
	This guarantee is offered by all banks and building societies that accept instructions to pay by Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit the Isle of Wight Council will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request the Isle of Wight Council 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 the Isle of Wight Council 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 the Isle of Wight Council 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.

	Business Rates Privacy Notice
	The Isle of Wight Council as data controller, will process your personal information contained in this application in accordance with the Data Protection Act 1998. Information may be shared with other departments within the Council for the recovery of any debts owed to the Council and to identify persons responsible for Business Rates and/or Council Tax & bringing empty properties back into use. Please note that the Council may share your information in the absence of consent, for the purpose of crime prevention or detection, in accordance with the law. Please click here to read the full Privacy Notice.

	Data Protection Act 1998
	This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request. The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy . Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest. Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law. Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

Date printed: 07/03/2013