application form trent motor traction company Ltd

fill in your personal details Step 1 Instructions to your Bank or Building Society to pay by Direct Debit

Date of Application Name and full postal address of your Bank or Building Society

Surname To: The Manager

Fornames Name of Bank/Building Society

Title Mr Mrs Miss

Date of Birth Address college / university / school Postcode current Address Name(s) of Account Holder(s)

1st Postcode 2nd Email Address Bank/Building Society Account Number

We regularly send out details of our special offers and promotions. Branch Sort Code

If you do not wish to receive these details by post, please tick the box For trentbarton Reference Number use only If you do not wish to receive these details by email, please tick the box Originators Identification Number 270221 Choose your card type: Town £28 per month Instruction to your Bank or Building Society Please pay trent motor traction Co Ltd Direct Debits from the account detailed in this Village £41 per month instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that Loughborough - Leicester £44 per month this Instruction may remain with trent motor traction Co Ltd and, if so, details will be passed electronically to my Bank/Building Society. Loughborough - Airport £48 per month

Loughborough - £48 per month Signature Universe £52 per month Date Step 2 Date preferred for your account to be debited, choose from the 10th or 25th of any month Banks and Building Societies may not accept Direct Debit Instructions for some types of account 1st choice or 2nd choice

Please allow 2 to 3 weeks to process. All Kinchkards are sold subject to the The Direct Debit Guarantee Company’s Conditions of Carriage. For Conditions and further • This Guarantee is offered by all banks and building societies that accept instructions information please ring 01773 712265. to pay Direct Debits

• If there are any changes to the amount, date or frequency of your Direct Debit Trent Motor Traction Co Ltd will notify you five working days in advance of your account Signature being debited or as otherwise agreed. If you request Trent Motor Traction Co Ltd to collect a payment, confirmation of the amount and date will be given to you at the Date time of the request.

Reference Number For Kinchbus • If an error is made in the payment of your Direct Debit, by Trent Motor Traction Co use only 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 Please tick this box if you do not wish to receive further information are not entitled to, you must pay it back when Trent Motor Traction Co Ltd asks you to regarding Kinchbus or its products. • You can cancel a Direct Debit at any time by simply contacting your bank or building Step 3 send the completed form to; society. Written confirmation may be required. Please also notify us. Kinchbus c/o FREEPOST 425, Road, , , DE75 9BR