I Have a Brain Injury

Direct Debit Mandate (SEPA)

This mandate will be returned securely to Acquired Brain Injury Ireland for processing. By completing this mandate form, you authorise Acquired Brain Injury Ireland to send instructions to your bank to (A) debit your account and (B) your bank to debit your account in accordance with the instructions from Acquired Brain Injury Ireland. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited. Your rights are explained in a statement that you can obtain from your bank.

Creditor’s name: Acquired Brain Injury Ireland

Creditor identifier: IE35SDD361503

Creditor address:
Acquired Brain Injury Ireland National Office,
2nd Floor, Block A Century Court, 100 George’s Street Upper, Dun Laoghaire, Co. Dublin, A96 R2V3