{"id":13886,"date":"2021-06-09T13:56:25","date_gmt":"2021-06-09T12:56:25","guid":{"rendered":"https:\/\/www.skipsandbins.com\/contract\/?page_id=13886"},"modified":"2025-05-15T16:33:12","modified_gmt":"2025-05-15T15:33:12","slug":"direct-debit-form","status":"publish","type":"page","link":"https:\/\/www.skipsandbins.com\/contract\/direct-debit-form\/","title":{"rendered":"Direct Debit Form"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column offset=&#8221;vc_col-md-2&#8243;][\/vc_column][vc_column offset=&#8221;vc_col-md-8&#8243;][vc_row_inner][vc_column_inner column_width_percent=&#8221;100&#8243; gutter_size=&#8221;2&#8243; style=&#8221;dark&#8221; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/1&#8243; uncode_shortcode_id=&#8221;172069&#8243; back_color_type=&#8221;uncode-solid&#8221; back_color_solid=&#8221;#ff0000&#8243;][vc_custom_heading text_color=&#8221;color-xsdn&#8221; heading_semantic=&#8221;h3&#8243; text_size=&#8221;h3&#8243; uncode_shortcode_id=&#8221;210255&#8243; text_color_type=&#8221;uncode-palette&#8221;]IMPORTANT![\/vc_custom_heading][vc_custom_heading text_color=&#8221;color-xsdn&#8221; heading_semantic=&#8221;p&#8221; text_size=&#8221;custom&#8221; uncode_shortcode_id=&#8221;564424&#8243; text_color_type=&#8221;uncode-palette&#8221; heading_custom_size=&#8221;20px&#8221;]<strong>The information you enter into this direct debit form <\/strong> <span style=\"text-decoration: underline;\">must<\/span> match your bank account to avoid direct debits being rejected by your bank. Please refer to your bank statement to ensure you enter the correct details. Thank you.[\/vc_custom_heading][\/vc_column_inner][\/vc_row_inner]<noscript class=\"ninja-forms-noscript-message\">\n\tNotice: JavaScript is required for this content.<\/noscript>\n<div id=\"nf-form-10-cont\" class=\"nf-form-cont\" aria-live=\"polite\" aria-labelledby=\"nf-form-title-10\" aria-describedby=\"nf-form-errors-10\" role=\"form\">\n\n    <div class=\"nf-loading-spinner\"><\/div>\n\n<\/div>\n        <!-- That data is being printed as a workaround to page builders reordering the order of the scripts loaded-->\n        <script>var formDisplay=1;var nfForms=nfForms||[];var form=[];form.id='10';form.settings={\"objectType\":\"Form Setting\",\"editActive\":true,\"title\":\"Direct Debit\",\"show_title\":0,\"allow_public_link\":0,\"embed_form\":\"\",\"clear_complete\":0,\"hide_complete\":1,\"default_label_pos\":\"above\",\"wrapper_class\":\"\",\"element_class\":\"\",\"key\":\"\",\"add_submit\":1,\"changeEmailErrorMsg\":\"Please enter a valid email address!\",\"changeDateErrorMsg\":\"Please enter a valid date!\",\"confirmFieldErrorMsg\":\"These fields must match!\",\"fieldNumberNumMinError\":\"Number Min Error\",\"fieldNumberNumMaxError\":\"Number Max Error\",\"fieldNumberIncrementBy\":\"Please increment by \",\"formErrorsCorrectErrors\":\"Please correct errors before submitting this form.\",\"validateRequiredField\":\"This is a required field.\",\"honeypotHoneypotError\":\"Honeypot Error\",\"fieldsMarkedRequired\":\" \",\"currency\":\"\",\"repeatable_fieldsets\":\"\",\"unique_field_error\":\"A form with this value has already been submitted.\",\"logged_in\":false,\"not_logged_in_msg\":\"\",\"sub_limit_msg\":\"The form has reached its submission limit.\",\"calculations\":[],\"conditions\":[],\"formContentData\":[{\"formContentData\":[\"alert_1643640055147\",\"business_name_1731426638505\",\"trading_as_1655803843443\",\"intro_1623243438334\",\"name_s_of_account_holder_s_1623242293638\",\"name_s_of_account_holder_s_02_1623242971716\",\"name_s_of_account_holder_s_03_1657194786314\",\"bank_building_society_account_number_1623242468296\",\"branch_sort_code_1623242484287\",\"bank_address_1623242638337\",\"bank_building_society_1623242632037\",\"bank_building_society_address_1623248247187\",\"bank_building_society_postcode_1623248257291\",\"reference_1623242751806\",\"instruction_1623243895727\",\"service_user_number_1623242816887\",\"official_note_1623243959487\",\"signature_s_1623242951448\",\"signature_s_02_1623242962730\",\"signature_s_03_1657194641644\",\"date_1623242986013\",\"direct_debit_note_1623243987545\",\"email_address\",\"i_we_confirm_that_i_we_are_the_only_person_people_authorised_to_make_debits_from_the_account_stated_1657194584717\",\"i_confirm_i_am_the_account_holder_stated_above_i_agree_i_have_checked_the_direct_debit_agreement_details_are_correct_1684156348812\",\"submit_1637243766784\"],\"order\":0,\"type\":\"part\",\"clean\":false,\"title\":\"Direct Debit Form\",\"key\":\"zjxbkjhx\",\"editActive\":true,\"drawerDisabled\":false}],\"drawerDisabled\":false,\"use_document_title\":1,\"document_title\":\"\",\"use_document_body\":1,\"document_body\":\"<div style=\\\"width:780px;text-align:center;display:block;float:left;\\\"><img src=\\\"https:\\\/\\\/www.skipsandbins.com\\\/contract\\\/sab-content\\\/uploads\\\/2021\\\/06\\\/form-directdebit.jpg\\\" style=\\\"width: 180px; height: 60px;\\\"><\\\/div>\\n    <div style=\\\"width:320px;display:block;float:left;clear:left;font-family:Arial, Helvetica, sans-serif;font-weight:500;font-size:12px;margin-right:20px;\\\"><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">SkipsAndBins.com Ltd<br>Hawthorne House<br>Blackthorn Way<br>Sedgeletch Industrial Estate<br>Fencehouses<br>Tyne and Wear<br>DH4 6JN<\\\/div>\\n    <span style=\\\"display:block;\\\"><b>Name(s) of account holder(s):<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:name_s_of_account_holder_s_1623242293638}<\\\/div>\\n<div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:name_s_of_account_holder_s_02_1623242971716}<\\\/div>\\n<div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:name_s_of_account_holder_s_03_1657194786314}<\\\/div>\\n<span style=\\\"display:block;\\\"><b>Bank\\\/building society account number:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:bank_building_society_account_number_1623242468296}<\\\/div>\\n<span style=\\\"display:block;\\\"><b>Branch sort code:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:branch_sort_code_1623242484287}<br><\\\/div>\\n<span style=\\\"display:block;\\\"><b>Name and full postal address of your bank or building society:<\\\/b><\\\/span><br><span style=\\\"display:block;\\\"><b>To: The Manager:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:bank_building_society_1623242632037}<br><\\\/div>\\n<span style=\\\"display:block;\\\"><b>Address:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:bank_building_society_address_1623248247187}<br><\\\/div>\\n<span style=\\\"display:block;\\\"><b>Postcode:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:bank_building_society_postcode_1623248257291}<\\\/div>\\n<span style=\\\"display:block;\\\"><b>Reference:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;\\\">{field:reference_1623242751806}<br><\\\/div>\\n<\\\/div>\\n<div style=\\\"width:320px;display:block;float:left;clear:none;font-family:Arial, Helvetica, sans-serif;font-weight:500;font-size:12px;\\\"><span style=\\\"font-family:Arial, Helvetica, sans-serif;font-size:22px;display:block\\\">Instruction to your bank or building society to pay by Direct Debit<\\\/span><br><span style=\\\"display:block;\\\"><b>Service user number<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:service_user_number_1623242816887}<\\\/div>\\n<div style=\\\"width:300px;padding:3px;border:2px solid #000000;font-size:10px;text-align:center;margin-bottom:4px;\\\">FOR SKIPSANDBINS.COM LTD OFFICIAL USE ONLY<br>This is not part of the instruction to your bank or building society.<br><br><img src=\\\"https:\\\/\\\/www.skipsandbins.com\\\/contract\\\/sab-content\\\/uploads\\\/2021\\\/06\\\/form-sab-logo.jpg\\\" style=\\\"width: 250px; height: 100px;\\\"><\\\/div>\\n<span style=\\\"display:block;font-size:10px;\\\"><b>Instruction to your bank or building society<\\\/b><br>Please pay SkipsAndBins.com Ltd Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with SkipsAndBins.com Ltd and, if so, details will be passed electronically to my bank\\\/building society.<\\\/span><br><span style=\\\"display:block;\\\"><b>Signature(s):<\\\/b><\\\/span><div style=\\\"width:300px;padding:4px;border:2px solid #000000;margin-bottom:4px;\\\">{field:signature_s_1623242951448}<br><\\\/div>\\n<div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:signature_s_02_1623242962730}<br><\\\/div>\\n<div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:4px;\\\">{field:signature_s_03_1657194641644}<br><\\\/div>\\n<span style=\\\"display:block;\\\"><b>Date:<\\\/b><\\\/span><div style=\\\"width:300px;padding:4px;border:2px solid #000000;margin-bottom:4px;\\\">{field:date_1623242986013}<br><\\\/div>\\n<span style=\\\"display:block;\\\"><b>Business Name:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;margin-bottom:8px;\\\">{field:business_name_1731426638505}<br><\\\/div>\\n<span style=\\\"display:block;\\\"><b>Trading As:<\\\/b><\\\/span><div style=\\\"width:300px;padding:3px;border:2px solid #000000;\\\">{field:trading_as_1655803843443}<br><\\\/div>\\n<\\\/div>\\n<div style=\\\"border-collapse:collapse;border-spacing:0;width:800px;text-align:center;display:block;float:left;\\\"><span style=\\\"text-align:center;font-weight:500;font-size:12px;font-family:Arial, Helvetica, sans-serif;\\\">Banks and building societies may not accept Direct Debit Instructions for some types of account. This guarantee should be retained by the payer.<br><\\\/span><\\\/div>\\n<div style=\\\"width:800px;text-align:center;padding:10px;border:4px solid #000000;display:block;float:left;\\\"><img src=\\\"https:\\\/\\\/www.skipsandbins.com\\\/contract\\\/sab-content\\\/uploads\\\/2021\\\/06\\\/form-directdebit.jpg\\\" style=\\\"width: 180px; height: 60px;\\\"><br><span style=\\\"width:800px;font-size:20px;font-weight:500;font-family:Arial, Helvetica, sans-serif;\\\">The Direct Debit Guarantee<\\\/span><ul style=\\\"text-align:left;font-weight:500;font-family:Arial, Helvetica, sans-serif;font-size:11px;\\\">\\n<li>This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits<\\\/li>\\n<li>If there are any changes to the amount, date or frequency of your Direct Debit SkipsAndBins.com Ltd will notify you 10 working days in advance of your account being debited or as otherwise agreed. 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Your direct debit will be taken within 10 and 14 days from the date of your order with us, a copy of which will be emailed to you.<\\\/p><p style=\\\"width:100%;padding:20px;border:3px solid #000000;\\\">SKIPSANDBINS.COM<br>HAWTHORNE HOUSE<br>BLACKTHORN WAY<br>SEDGELETCH INDUSTRIAL ESTATE<br>FENCEHOUSES<br>TYNE AND WEAR<br>DH4 6JN<\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"intro_1623243438334\",\"drawerDisabled\":false,\"admin_label\":\"\",\"id\":186,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<p>Please fill in the required information below and click 'Submit' to setup your direct debit payments with us. 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society.<\\\/p><p><img src=\\\"https:\\\/\\\/www.skipsandbins.com\\\/contract\\\/sab-content\\\/uploads\\\/2019\\\/08\\\/sab-logo-500.png\\\" style=\\\"width: 262.361px; height: 102px;\\\"><\\\/p><p><b>Instruction to your bank or building society<\\\/b><br>Please pay SkipsAndBins.com Ltd Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with SkipsAndBins.com Ltd and, if so, details will be passed electronically to my bank\\\/building society.<\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"official_note_1623243959487\",\"drawerDisabled\":false,\"admin_label\":\"\",\"id\":198,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<p>FOR SKIPSANDBINS.COM LTD OFFICIAL USE ONLY.<br>This is not part of the instruction to your bank or building society.<\\\/p><p><img src=\\\"https:\\\/\\\/www.skipsandbins.com\\\/contract\\\/sab-content\\\/uploads\\\/2019\\\/08\\\/sab-logo-500.png\\\" style=\\\"width: 262.361px; height: 102px;\\\"><\\\/p><p><b>Instruction to your bank or building society<\\\/b><br>Please pay SkipsAndBins.com Ltd Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with SkipsAndBins.com Ltd and, if so, details will be passed electronically to my bank\\\/building society.<\\\/p>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":18,\"idAttribute\":\"id\",\"type\":\"textbox\",\"label\":\"Signature(s)\",\"key\":\"signature_s_1623242951448\",\"label_pos\":\"above\",\"required\":1,\"default\":\"\",\"placeholder\":\"Type your full name to agree to this direct debit...\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"value\":\"\",\"drawerDisabled\":false,\"id\":199,\"beforeField\":\"\",\"afterField\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":19,\"idAttribute\":\"id\",\"type\":\"textbox\",\"label\":\"Signature(s) 02\",\"key\":\"signature_s_02_1623242962730\",\"label_pos\":\"hidden\",\"required\":0,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"value\":\"\",\"drawerDisabled\":false,\"id\":200,\"beforeField\":\"\",\"afterField\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":20,\"idAttribute\":\"id\",\"type\":\"textbox\",\"label\":\"Signature(s) 03\",\"key\":\"signature_s_03_1657194641644\",\"label_pos\":\"hidden\",\"required\":0,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"\",\"manual_key\":true,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"value\":\"\",\"drawerDisabled\":false,\"id\":246,\"beforeField\":\"\",\"afterField\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":21,\"idAttribute\":\"id\",\"type\":\"textbox\",\"label\":\"Date\",\"key\":\"date_1623242986013\",\"label_pos\":\"above\",\"required\":1,\"default\":\"{other:date}\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"\",\"manual_key\":false,\"disable_input\":1,\"admin_label\":\"\",\"help_text\":\"\",\"disable_browser_autocomplete\":1,\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"value\":\"04\\\/09\\\/2026\",\"drawerDisabled\":false,\"id\":201,\"beforeField\":\"\",\"afterField\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":22,\"idAttribute\":\"id\",\"type\":\"html\",\"label\":\"Direct Debit Note\",\"default\":\"<p>Banks and building societies may not accept Direct Debit Instructions for some types of account.<br><\\\/p><p>This guarantee should be retained by the payer. 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