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ONLY COMPLETE THE FORM BELOW IF YOU ARE PAYING ANNUALLY BY CREDIT/DEBIT CARD (see overleaf if your chosen option of payment is monthly by direct debit)

ANNUALLY CREDIT / DEBIT CARD INSTRUCTION

ONLY FILL IN THIS SECTION IF YOU ARE PAYING ANNUALLY THROUGH YOUR BANK CREDIT/DEBIT CARD.

I hereby authorise Thistle Tenant Risks to collect my annual premium through my Bank/Credit card

Card No:

Expiry Date:

Security Code:

(last 3 digits on signature strip)

Issue No:

Signature (s)

Date:

Made with