DIRECT DEBIT FORM

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Services of Interest *

Section 1 - Company Details

Please provide details of person (cardholder) making payment by credit card







Section 2 - Debit or Credit Card Details






I, the Cardholder, authorise We Are Web to debit this credit/debit card for all existing and future invoices as and when they fall due and in the event of any change in the charges for these services to alter the amount from the appropriate date in accordance with such change. This authority shall stand, in respect of this Card and in respect of any Card issued to you in renewal or replacement thereof, until you notify us in writing of cancellation. You acknowledge that it is your responsibility to ensure there is enough funds available in the Account to permit the payment of services and additional fees may apply for reprocessing failed transactions

The following surcharges apply to credit card transactions. American Express & Diners – 2.5%
This payment authority is subject to an existing contract and is governed by the specific terms of the contract

CCAuth/20162510/WAWCC