Lenomedia - Debit order mandate
Please fill out the following form
Company Registration Number
Project – For example: Hosting, Maintenance etc.*
Address line 2
State / Province / Region
ZIP / Postal Code
Branch & Code*
Type of Account*
Amount (amount that will be debited from your account)*
Abbreviated Name as Registered with the Bank (Bank Reference on your statement): Lenomedia
I/We acknowledge that all payment instructions issued by you shall be treated by my/our above mentioned Bank as if the instructions have been issued by me/us personally.
I/We agree that although this Authority and Mandate may be canceled by me/us, such cancellation will not cancel the Agreement. I/We shall not be entitled to any refund of amounts which you have withdrawn while this Authority was in force, if such amounts were legally owing to you.
I/We acknowledge that this Authority may be ceded or assigned to a third party if the Agreement is also ceded or assigned to that third party, but in the absence of such assignment of the Agreement, this Authority and Mandate cannot be assigned to any third party.
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Document Name: Lenomedia - Debit order mandate
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