Mandate reference number*
Number/ Text
Enter the mandate reference number.
Mandate signature date
Date
Select the mandate signature date.
Mandate agreement date*
Date
Select the mandate agreement date.
Mandate expiration date*
Date
Select the mandate expiration date.
Allow recurring payments
Checkbox
Select the checkbox, if you want to allow recurring payments.
Source name
Number/ Text
Enter the mandate source name.
Source ref
Number/ Text
Enter the mandate source reference.
Name*
Text/ Number
Enter the debtor name.
Person type*
List
Select the debtor person type:
Private,
Legal.
Account number*,
type
Number/Text,
List
Enter the account number and select account type.
Account number country code
List
Select the account number code.
Financial institution ID
Number/Text
Enter the financial institution ID.
Street 1
Text/Number
Enter the street name.
Street 2
Text/Number
Enter the street name.
City / County
Text/Number
Enter the name of the city or county.
State / Region
Text/Number
Enter the name of the state or region.
Zip
Number/Text
Enter the zip code.
Country
List
Select the country from the list.
Address line
Text/Number
Enter the address information.
Choose file
Button
Click the button to upload mandate-related files.