Talon by MerlinVet

Title

First Name

Middle Name

Last Name

Phone

Email

Address 1

Address 2

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Postcode

Country

The Pet lives at the same address

Address 1

Address 2

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County

Postcode

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Name on the account

Account Number

Sort Code

This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
If there are any changes to the amount, date or frequency of your Direct Debit Merlin Simple Payment Solutions Ltd will notify you 7 working days in advance of your account being debited or as otherwise agreed. If you request Merlin Simple Payment Solutions Ltd to collect a payment, confirmation of the amount and date will be given to you at the time of the request.
If an error is made in the payment of your Direct Debit, by Merlin Simple Payment Solutions Ltd or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society – If you receive a refund you are not entitled to, you must pay it back when Merlin Simple Payment Solutions Ltd asks you to.
You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Payment Total

£

Total due today

Card Holder's Email Address

I understand that this is NOT an insurance policy

I read the Terms and Conditions of the agreement

I am the account holder & the only person required to authorise Direct Debit payments on this account

Direct Debit payment solutions provided by MerlinSPS Ltd who can be contacted directly at office@merlinsps.co.uk or on 01573 401421