I / We authorize WIST OÖ to collect payments from my / our account using SEPA direct debit. At the same time, I / we instruct our bank to honor the SEPA direct debit mandate drawn by WIST OÖ on my / our account. I / We can request reimbursement of the debited amount within eight weeks, starting with the debit date. The conditions agreed with my / our bank apply.

Name tenant*

E-mail tenant*

House*
WIST Barbara Single RoomWIST Barbara - Wohnung Eingang 70WIST Barbara - Wohnung 72WIST BrunoWIST ErnstWIST JohannaWIST Franz - OÖ-Heim

Name of account holder*

Account holder address*

IBAN*

BIC*

Signature*
[signature signature-626 color:#000000 backcolor:#ffffff width:450 height:150]

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