FlexPay

Flexible Ways for Businesses and Customers to Pay

Statement
Your details
Sponsor
Services/products

FLEXPAY CUSTOMER STATEMENT

You have elected not to pay in full, instead preferring to pay in instalments for this product or service through a FlexPay payment plan.

This is not a credit agreement or an application for credit, and will not affect your credit score. FlexPay will instead administer and manage your payment plan on our behalf for a fee of (£7.00 + vat) per month, which will be added to your total balance for each month that the plan is active. You may also incur bank or transaction charges from your own provider, for which we, nor FlexPay, is responsible.

The full administration fee owed will be taken with your first monthly instalment.

If you don't set up your payment plan or it defaults for more than 30 days, you may incur debt recovery charges of up to 15.00% of the remaining balance. If a payment instalment fails, you may also incur a chargeback fee.

By requesting this payment plan you also consent for us to pass your contact details, including name, address, email and telephone numbers to FlexPay for the purpose of administering this service.

You will shortly receive an email containing a link in order to create your account.

Are you happy to continue on this basis?

Tick here

Name *

Date

Please have no gaps in phone numbers

I already have a FlexPay account

Email *

Email 2 (optional)

Title *

First Name *

Surname *

Date of Birth *

Address line 1 *

Address line 2

Address line 3

Post code *

Country *

Mobile Code *

Mobile *

Code

Land Line (Optional)

Code

Work Number (Optional)

Emergency Contact (optional)

Emergency Email (optional)

Please note we will never discuss the account with a third party without the customer’s permission.

Title *

First name (and any middle names):

Last name/business name

Date of Birth *

Address line 1

Address line 2

Address line 3

Post code *

Country *

Email *

Email 2

Mobile Code *

Mobile *

Code

Land Line (Optional)

Code

Work Number (Optional)

Note

Supply Name *

Start date (what's this?)

Length of supply

nature of supply

End date (what's this?)

No Of breaks

Total cost (incl VAT)

VAT Percentage

Product	Start date	nature of supply	end date	Re input end date	total cost (incl VAT)	deposit paid (incl VAT)	net total cost (incl VAT)	Total cost for plan	First instalment	Other instalment	net total to pay for new plan at end month 12	VAT %	Total to pay on new Plan	Remove