Direct Debit (SEPA) Restriction Application Form

AIB Direct Debit (SEPA) Restriction Application Form

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To add, amend or remove restrictions at account or mandate level

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LETTERS and leave one

space between each word

A 2

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and mark the correct box

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How to complete the form

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BLACK pen

Application Date

MonthDay Year

/ /

To the Manager AIB

I/We hereby authorise and request you to apply direct debit restriction changes on my/our account

NSC

9 3 - -

Account Number

IBAN

Restriction Type: Account Level Restriction Or Mandate Level Restriction

Account Level Restriction

OIN

Account Restriction Type (only one option to be selected)

Add Blacklist Remove Blacklist Add Whitelist Remove Whitelist

Blacklist All Remove Blacklist All

Mandate Level Restriction

UMR

Mandate Restriction Type (please mark ( ) in the below boxes e.g. Amount limit and Add/Remove)

Amount Limit Frequency Restriction Both

Add

Remove

Amount Limit

€

Please select frequency required: Weekly Monthly Quarterly Annually

Signature Signature

AIB Direct Debit (SEPA) Restriction Application Form

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Allied Irish Banks, p.l.c. is regulated by the Central Bank of Ireland

Allied Irish Banks, p.l.c., Registered Oce, 10 Molesworth Street, Dublin 2, Registered in Ireland, Number 24173

AIB/DDRA 06/20

Help in completing a Direct Debit (SEPA) Restrictions Application Form

Account Level Restrictions

Account level restrictions service can be used to restrict your account from being debited for SEPA direct debits or only

allow specic originators from debiting your account. Through this service you can add/amend the below Account level

Direct Debit Restrictions. Account level restrictions are set against your originators Originator Identication Number (OIN)

which can be obtained from your SEPA Direct Debit Mandate or from your local branch.

Mandate Level Restrictions

Mandate level restrictions service can be used to apply restrictions against your originator’s Unique Mandate Reference

(UMR) which is listed on your SEPA Direct Debit mandate or can be obtained from your local branch. Through this

service you can add/amend the below Mandate level Direct Debit Restrictions.

Important notes on lling out this application

• Only one application can be submitted for either Account Level or Mandate Level Restrictions.

• To apply Account Level Restrictions for multiple accounts, a separate application form for each Account is required.

• To apply Mandate Level Restrictions for multiple UMR’s, a separate application form for each Mandate is required.

• Only either Whitelisting or Blacklisting will be allowed against an account at any point of time.

• Blacklist All service request can be submitted at any time despite existence of Whitelist or Blacklist.

• For Blacklist All or Remove Blacklist All service, the OIN is not required.

• The frequency restriction will come into eect for all collections received on the mandate after the restriction has

been set up.

• The frequency restriction period is dened by calendar days (Monday - Sunday). For example, if a weekly restriction

is set up and a collection is presented on Thursday in Week 1, the next collection will be accepted from Monday

onwards the following week.

• By setting up a frequency limit on a direct debit mandate you are agreeing that you will not want to pay a direct

debit more than that frequency. Any collection that is received breaching this frequency restriction will be returned

unpaid, in full.

• The frequency restriction will remain in place until you request that it is removed.

• Account level restrictions will always take precedence over Mandate Level Restrictions.

• Both Account & Mandate Level Restrictions should be applicable only for incoming Direct Debit collections.

Service What does this mean?

Add Blacklist Blocking of specic OIN from debiting your account

Add Whitelist Allowing specic OIN from debiting your account

Blacklist All Blocking your account from all Direct Debit payments

Remove Blacklist Removing specic OIN from Blacklisting

Remove Whitelist Removing specic OIN from Whitelisting

Remove Blacklist All Removing all account level restrictions from your account

Service What does this mean?

Amount Based Restricting the amount that can be debited from your account eg. if the restriction is set

as €50, then any Direct Debit payment greater than €50 will be rejected.

Frequency Restrictions Restricting Direct Debit payments within a certain frequency e.g. if the restriction is set

Monthly, then if a restricted Direct Debit attempts to collect more than once a month it

will be rejected.

Both Restricting direct debit payments with both Amount & Date Restrictions, i.e. direct debit

payments which satisfy both the amount limit & date restrictions will be processed.

For Bank Use Only

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