Direct Debit Form

Direct Debit Details

*- indicates required field.

Please choose what you would like to do. *

Establish a new direct debit

Change an existing direct debit

Please choose what payment the direct debit relates to. *

Rates

Water

Both Rates and Water

I/We authorise Gisborne District Council to send Direct Debits to my account for the purpose of the above payment(s).

(optional)

Name of applicant: *

Name of ratepayer(s) (if different to applicant): (optional)

Postal address *

may be different to property address for direct debit.

Contact number: *

Email address: *