Consent form for instalments by direct debit

You can use this form (Dutch only) to give your consent. Before printing, fill in the form completely. Do not forget to add your signature to the form after printing. Send the form to GBLT, PO Box 1098, 8001 BB Zwolle.

Please note: it takes at least two weeks for the direct debit to be organised with the consent form. The payments will begin after we have processed your consent.