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By completing this form you are authorising to collect from your account via Direct Debit. You will be notified before any payment is collected.
Please provide your contact information
Please enter the bank account details you'd like to use for Direct Debit payments
Please review your information before authorising your Direct Debit
Bank statement: Payments will appear on your bank statement as L&Z RE RIPPLE PAY.
Confirmation: Confirmation of this Direct Debit Instruction will be sent to you within 3 working days of the Instruction being set up, or no later than 10 working days before the first collection.
Thank you, . Your Direct Debit has been successfully authorised.
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Your Direct Debit mandate is authorised, but your application hasn’t been submitted yet. Please return to the previous tab and click Submit Application to complete signup.
If you close this tab without going back, we won’t receive your application.
Questions? Contact Roots by the Sea Ltd: