Appendix 2 to Annex B - Particulars to be supplied in the batch debit order
Name and address of user:
Number of user's deposit account:
Number of diskette:
Date diskette prepared:
Number of fees to be debited:
Total payments in euro:
Hash total of application numbers:
Additional immediate printout of debited fees:
Yes/No
Contact person in event of problems:
- Name
- Telephone number
- Telex number
- Fax number
Request for batch debiting by diskette
Place
Date
Signature