Lighthouse Networks

SEPA Direct Debit Payment

• Unique Mandate Reference (UMR):
  If the UMR is not available at this time it will be advised to you later by writing

  Leave this field blank if the UMR is not currently available

• Type of Payment:
  Recurring
  Once Off

  Only recurring payments are supported at this time

Please enter your details below

• Account Holder's Name:
• Address of Account Holder:
  Address Line 1
  Address Line 2
  City / County
• Phone Number:

  Please provide a daytime contact phone number

• Email Address:

  Direct Debit Confirmation and future Invoices will be sent to this email address

Customer Bank Account Details

SEPA Direct Debits authorised online can only be processed on bank accounts held in the Republic of Ireland. If your account is in another country you will need to submit a paper SEPA Direct Debit mandate

• BIC (8 or 11 characters e.g. AIBKIE2DXXX):
• IBAN (22 characters e.g. IE29AIBK93115212345678):

• Online Direct Debit mandates can only be accepted for bank accounts held in the Republic of Ireland

• Is this Bank account a Republic of Ireland bank account? Yes
  No

• If you have an account that requires more than one signature then a paper Direct Debit Mandate must be completed

• Is more than one signatory required to sign on your account? Yes
  No

• Have you used this account to make Direct Debit payments before as some Banks or Building Societies may not accept Direct Debits for certain types of account

• Can the bank account accept Direct Debits? Yes
  No

SEPA Creditor Identification Number: IE52ZZZ305325

Creditors Name and Address: Lighthouse Networks Ltd, Beech House, East Point Business Park, Loughrea, Co. Galway

Telephone: 091-395804