Direct Debit Permission

Name
MM slash DD slash YYYY
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By completing this form, you are providing personal information to RSPCA NSW (we, us, or our). We are collecting your personal information to request your permission for a direct debit. Supplying your personal information is voluntary, but it may impact our ability to process your direct debit if you do not provide it. Further details about how we manage personal information is contained in our Personal Information Collection Notice  and Privacy Policy. By submitting this form, you confirm that you have read and agree to the terms of our Personal Information Collection Notice.