Direct Debit Setup

Fill in the following secure form to set up your Direct Debit with LifeConnect24!

  • Account Details

    These details can be found on your cheque book, bank statement, or bank card.
  • Account Number must be 8 digits long.
  • Customer Details

  • Enter your customer reference number, if known.

* By clicking “Submit”, I confirm that I agree to the terms below and wish to start a Direct Debit with LifeConnect24.


Terms & Conditions

The “payer” is the person to whom the details in the above form relate. By clicking submit you agree that:

1. The payer identified above is who you claim they are.
2. The address provided above is that of the payer.
3. The bank account number and sort code provided above relate to the payer.
4. The person filling out this form is authorised to sign on the bank account for which the details are provided.

If you are not the account holder or your account requires more than one signature a paper Direct Debit Instruction will be required to be completed and posted to us.

All the normal Direct Debit safeguards and guarantees apply. No changes in the amount, date, frequency to be debited can be made without notifying you at least 5 working days in advance of your account being debited. In the event of any error, you are entitled to an immediate refund from your Bank or Building society. You have the right to cancel a Direct Debit Instruction at any time simply by writing to your Bank or Building Society, with a copy to us.

Call us : 0800 999 0400

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