REPAK Ltd SEPA Direct Debit

To complete this online application form you will require specific information relating to your business. Please see the checklist below.

Member Number

Please enter your Repak membership number with no leading 0's

Repak Member Number Apply

Is more than 1 signatory required to sign on your account

If your account requires more than one signature you will be redirected to a pdf version of our SEPA Direct Debit Mandate Form

Yes

Mandate Form

Due to the criteria you have selected you will be unable to complete this SEPA Direct Debit Mandate online. Please download and complete the PDF version of the form and sent to Repak Ltd via post or email.

accountsreceivable@repak.ie

Repak Limited
Red Cow Interchange Estate
1 Ballymount Road, Clondalkin, Dublin 22,
Eircode: D22 HW67

Is the bank account a ROI bank account?

If your account is not an ROI bank account you will be redirected to a pdf version of our SEPA Direct Debit Mandate Form

Yes

Mandate Form

accountsreceivable@repak.ie

Repak Limited
Red Cow Interchange Estate
1 Ballymount Road, Clondalkin, Dublin 22,
Eircode: D22 HW67

Company Name

Company Email

Company Address

City

Eircode

Country

Company Account No. - IBAN

All upper case, no spaces.

IBAN

Company Bank Identifier Code - BIC

All upper case, no spaces.

BIC

UMR

Your UMR is your member number as it appears on your invoice.

Creditor Bank Details

Name

Identifier

Address

City

Eircode

Recurring

Repak Limited SEPA Direct Debit Mandate

By signing this mandate form, you authorise (A) Repak Ltd. to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instructions from Repak Limited. 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 which your account was debited.

Note: Your rights are explained in a statement that you can obtain from your bank.

Signature

Date

This form has not been submitted due to the criteria selected. Please download and complete the PDF version and send to Repak Ltd.