Direct Debit Monthly Donations

Please complete the below form if you would like to set up a monthly direct debit donation in aid of Barretstown.

Name*
First Last
Address
Street Address City County / State / Region ZIP / Postal Code Country
Email
Phone
Untitled*
- Phone
- Email
- Please do not contact me
I want to help all year round with a monthly donation:*
- €10
- €15
- €21*
* If you pay tax & donate €250 or more to us in any year, we can reclaim the tax paid on your donation at no extra cost to you.

Your account will be debited on the 1st of the month.
*IBAN*
*BIC*
Signature
Date
MM slash DD slash YYYY
By signing this mandate form, you authorise (A) Barretstown to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instructions from Barretstown. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited.

You can find your IBAN and BIC numbers on your bank statement, or by calling your bank. Creditor: Barretstown. Credit Identifier: IE52ZZZ305616. Creditor Address: Barretstown Castle, Ballymore Eustace, Co Kildare.

Note: Your rights regarding the above mandate are explained in a statement that you can obtain from your bank. Please send this mandate to the creditor.