5 Trinity Street, London SE1 1DB. 020 7921 2200
Direct Debit Instruction - please complete in full
Name and full postal address of your Bank or Building Society
Names(s) of Account Holder(s)
Bank / Building Society account number
Branch sort code --
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Instruction to your Bank or Building Society to pay by Direct Debit
Service User Number
4
2
8
7
7
8
Instruction to your Bank/Building Society
Please pay USPG:
Direct Debits from the account detailed in this Instruction subject to the safeguards assured
by the Direct Debit Guarantee. I understand that this Instruction may remain with USPG and, if so, details will be passed electronically to my Bank/Building Society.
Date: 13th December, 2024 (Banks and Building Societies may not accept Direct Debit instructions for some types of account.)
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