Direct debit mandate

Use a direct debit mandate to arrange automatic payment of AquaGib bills.

What you will need

Prefer a paper form? Download the Direct Debit mandate (PDF). Print and complete it, then return it to AquaGib by post.

Fields marked * are required when they apply to your application.

After changing the application type, use Update document requirements to show the documents needed. Complete only the fields that apply to you.

Application type *

Email *

Full legal name, including middle names *

For: Account in my name

First applicant: full legal name *

For: Joint account

Second applicant: full legal name *

For: Joint account

Company name *

For: Business account

Reference number as shown on your bill *

Bank or building society *

Bank address *

Bank account number *

Bank sort code (NN-NN-NN) *

Billing address *

Telephone number *

Supporting documents

One PDF, PNG, JPG or BMP per document, up to 10 MB each.

Identity document *

Complete the required fields and supporting documents.