Authorisation to make payment via direct debit  Date    Authorisation to open up/change direct debit Authorisation to close/remove direct debit Payment recipient Company X Company Y Payment sender Name  Personal no.  Street, PO box etc.  Mobile phone no.  Postcode and town  Email address  If the authorisation covers only transfers under a certain customer number(s), please give the nr(s) here VAT No.  All customer numbers connected to company reg.no.  To be transferred from the given account Important that company reg. no./personal ID no. is corresponding with the account no. Bankgiro PlusGiro (IBAN only) Bank account Bankgiro number  PlusGiro number  Clearing  Bank account number  Bank with whom the account is held  * TermsAutogiro.pdf (Close) I confirm with my electronic signature that I have read the “Terms Autogiro".