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Direct debit form - ICO

8 0 8 6 3 4 Registration reference: Postcode Address To The Manager Bank/Building Society Telephone Number Signature(s) ---------------------------------------- ---------------------------------------- ---------------------------------------- ----Instruction to your Bank or Building Society to pay by Direct debit Please fill in the whole form using a ball point pen and send it to: Registration and Renewals Information Commissioner's Office wycliffe House Water Lane Wilmslow, Cheshire SK9 5AF or email to Name(s) of Account Holder(s) Branch Sort Code Bank/Building Society account number Name and full postal address of your Bank or Building Society Originator s Identification Number FOR INFORMATION COMMISSIONER S OFFICE OFFICIAL USE ONLY This is not part of the Instruction to your Bank or Building Society Instruction to your Bank or Building Society Please pay

Wycliffe House Water Lane Wilmslow , Cheshire SK9 5AF or email to dataprotectionfee@ico.org.uk . Name(s) of Account Holder(s) Branch Sort Code Bank/Building Society account number Name and full postal address of your Bank or Building Society Originator’sIdentificationNumber. FOR INFORMATION COMMISSIONER’S OFFICE OFFICIAL …

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