Mandato Sepa

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Orden de domiciliación de adeudo directo SEPA

SEPA Direct Debit Mandate

ACREEDOR / CREDITOR

Referencia de la orden de domiciliación / Mandate reference: UPCTACA0020637200041798


Identificador del acreedor / Creditor Identifier: ES08001Q8050013E
Nombre del acreedor / Creditor's name: UNIVERSIDAD POLITECNICA DE CARTAGENA
Dirección / Address: Pza. del Cronista Isidoro Valverde, Edif. La Milagrosa
Código postal - Población - Provincia / Postal Code - City - Town: 30202 CARTAGENA - Murcia
País / Country: ESPAÑA

Mediante la firma de esta orden de domiciliación, el deudor autoriza (A) al acreedor a enviar instrucciones a la entidad del deudor para adeudar su cuenta y (B) a
la entidad para efectuar los adeudos en su cuenta siguiendo las instrucciones del acreedor. Como parte de sus derechos, el deudor está legitimado al reembolso
por su entidad en los términos y condiciones del contrato suscrito con la misma. La solicitud de reembolso deberá efectuarse dentro de las 8 semanas que siguen
a la fecha en que se realizó el adeudo en cuenta. Puede obtener información adicional sobre sus derechos en su entidad financiera.
By signing this mandate form, you authorise (A) the Creditor to send instructions to your bank to debit your account and (B) your bank to debit your account in
accordance with the instructions from the Creditor. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your
agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited. Your rights are explained in a
statement that you can obtain from your bank.
ESTUDIANTE / STUDENT

Nombre del alumno (si es distinto del deudor) / Student's name (if different from debtor) NIF / Tax ID number
LUCIA GIMENEZ GALIAN 48842124Z
Correo / Email address
luciag.galian@gmail.com

A CUMPLIMENTAR POR EL DEUDOR / TO BE COMPLETED BY THE DEBTOR

Nombre del deudor (titular de la cuenta de cargo) / Debtor name (bank account holder(s) name(s)) NIF / Tax ID number
JOSE JUAN GIMENEZ GALIAN 77511404R
Dirección del deudor / Address of the debtor

Código postal - Población - Provincia / Postal Code - City - Town

País del deudor / Country of the debtor

Swift BIC / Swift BIC Número de cuenta - IBAN / Account number - Iban
BSABESBBXXX ES3700817362160001107415
Tipo de pago / Type of payment: Pago recurrente / Recurrent payment
Localidad - Fecha de firma / Location - Date in which you are signing:
20-09-2021

Firma del deudor / Signature of the debtor:

MANDATO YA FIRMADO

TODOS LOS CAMPOS HAN DE SER CUMPLIMENTADOS OBLIGATORIAMENTE


UNA VEZ FIRMADA ESTA ORDEN DE DOMICILIACIÓN DEBE SER ENVIADA AL ACREEDOR PARA SU CUSTODIA.
(ENTREGAR EN LA SECRETARÍA DE ALUMNOS DE SU CENTRO)
ALL GAPS ARE MANDATORY. ONCE THIS MANDATE HAS BEEN SIGNED MUST BE SENT TO THE CREDITOR FOR STORAGE.
(KIND TO HAND OVER TO YOU COLLEGE STUDENT SECRETARY)
CLÁUSULA DE PROTECCIÓN DE DATOS PERSONALES EN LA PÁGINA SIGUIENTE
PERSONAL DATA PROTECTION DISCLAIMER IN NEXT PAGE
PROTECCIÓN DE DATOS: en cumplimento de la Ley 15/1999, de 13 de diciembre, de Protección de datos de carácter personal, se
informa que los datos personales recogidos en este formulario serán incorporados, a alguno de los siguientes ficheros, según la finalidad a
la que corresponde:

PERSONAL DATA PROTECTION: complying with 15/1999 Act, dated December 13rd, for Personal Data Protection, it is hereby advised
that personal data collected through this form will be added into any one of the following files, depending on the purpose to which it belongs:
-''Undergraduate Courses Registration'', whose body responsible is the Vice Rectorship for Students, which is used to register enrollment
and progress of Undergraduate Students: enrollment process, payments, grade lists, certifications, economic control, etc.
-''Postgraduate Studies Registration'', whose body responsible is the Vice Rectorship for Students, which is used to register enrollment and
progress of Graduate Students:enrollment process, payments, graduate lists, certifications, economic control, etc.
-''Doctorate'', which is used to register enrollment of PhD students: enrollment process, doctorate lists, certifications, economic control and
realization of PhD thesis. The body responsible for the file is the Vice Rectorship for Students,.
Data might be given to financial companies and to other organizations from National or Region Government performing the same duties for
which this file is intended, besides others foreseen by Law. You may exercise your access, modification, cancellation and opposition rights
to the Archivo General y Protección de Datos of the University.

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