pay.gocardless.com
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Submitted URL: https://u1827704.ct.sendgrid.net/ls/click?upn=vucTPl16HIiVsrfG7L7R94CxvBnPYrsf3DKrT0IjIIVolUBL8e2hqOZsfXBNN4XzfMbMJHe3zmyeBE2FWTy...
Effective URL: https://pay.gocardless.com/billing/static/flow?id=BRF000VFX9B50MC35XWA2CHTDWDJX2X9
Submission: On December 21 via manual from IN — Scanned from DE
Effective URL: https://pay.gocardless.com/billing/static/flow?id=BRF000VFX9B50MC35XWA2CHTDWDJX2X9
Submission: On December 21 via manual from IN — Scanned from DE
Form analysis 1 forms found in the DOM
<form novalidate="">
<div class="css-1k2l5m6"><label class="css-u6nhba"><label class="css-u6nhba">Country of residence</label></label>
<div data-field-control="true" class="css-10g9r4y">
<div data-field-control="true" class="css-79elbk"><select name="country_code" id="country_code" data-testid="country-residence-selector" class="css-1rpo64z">
<option disabled="" value="DEFAULT" hidden="">Please select your country</option>
<option value="AX">Åland Islands </option>
<option value="AU">Australia </option>
<option value="AT">Austria </option>
<option value="BE">Belgium </option>
<option value="CA">Canada </option>
<option value="CY">Cyprus </option>
<option value="DK">Denmark </option>
<option value="EE">Estonia </option>
<option value="FO">Faroe Islands </option>
<option value="FI">Finland </option>
<option value="FR">France </option>
<option value="GF">French Guiana </option>
<option value="DE">Germany </option>
<option value="GR">Greece </option>
<option value="GL">Greenland </option>
<option value="GP">Guadeloupe </option>
<option value="IS">Iceland </option>
<option value="IE">Ireland </option>
<option value="IT">Italy </option>
<option value="LV">Latvia </option>
<option value="LT">Lithuania </option>
<option value="LU">Luxembourg </option>
<option value="MT">Malta </option>
<option value="MQ">Martinique </option>
<option value="YT">Mayotte </option>
<option value="MC">Monaco </option>
<option value="NL">Netherlands </option>
<option value="NZ">New Zealand </option>
<option value="PT">Portugal </option>
<option value="RE">Réunion </option>
<option value="BL">Saint Barthélemy </option>
<option value="MF">Saint Martin </option>
<option value="PM">Saint Pierre and Miquelon </option>
<option value="SM">San Marino </option>
<option value="SK">Slovakia </option>
<option value="SI">Slovenia </option>
<option value="ES">Spain </option>
<option value="SE">Sweden </option>
<option value="GB">United Kingdom </option>
<option value="US">United States </option>
</select><svg width="1em" height="1em" viewBox="0 0 16 16" xmlns="http://www.w3.org/2000/svg" role="img" fill="currentColor" aria-hidden="true" class="css-1g5yugn">
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</svg></div>
</div><span aria-hidden="true" data-flux-role="spacer" class="css-1yftlp5"></span>
</div>
<h5 class="css-1ynubir">Your company details</h5><span aria-hidden="true" data-flux-role="spacer" class="css-1cqmfhn"></span>
<div class="css-1k2l5m6">
<div class="css-17yo9k">
<div class="css-kbrvwq">
<div class="css-1rx3nga">
<div data-field-control="true" class="css-10g9r4y"><label for="company_name" class="css-u6nhba">Company name </label>
<div data-field-control="true" class="css-b2kbt5"><input name="company_name" id="company_name" class="css-1utqoku" value="Ariella McCauley Ref 074743238"></div>
</div>
</div>
</div>
</div><span aria-hidden="true" data-flux-role="spacer" class="css-1mq8x52"></span><button tabindex="-1" class="fs-unmask css-1he4hdw" type="button" style="font-weight: 600; font-size: 14px;"><span class="css-y6l269">or click here to use your
name</span></button>
</div><span aria-hidden="true" data-flux-role="spacer" class="css-1yftlp5"></span>
<div class="css-1k2l5m6">
<div class="css-1rx3nga">
<div data-field-control="true" class="css-10g9r4y"><label for="email" class="css-u6nhba">Email address </label>
<div class="css-1qx2cze">
<div class="css-149f8cc">
<div>We'll only use this to keep you updated about your payment</div>
</div>
</div>
<div data-field-control="true" class="css-b2kbt5"><input type="email" name="email" id="email" class="css-1utqoku" value="jeremy.jones@directlinegroup.co.uk"></div>
</div>
</div>
</div><span aria-hidden="true" data-flux-role="spacer" class="css-1yftlp5"></span>
<div role="combobox" aria-haspopup="listbox" aria-owns="react-autowhatever-1" aria-expanded="false" style="position: relative; z-index: 2;">
<div data-field-control="true" class="css-10g9r4y"><label class="css-u6nhba">Billing address</label>
<div data-field-control="true" class="css-b2kbt5"><input type="text" autocomplete="off" aria-autocomplete="list" aria-controls="react-autowhatever-1" placeholder="Start typing your postcode and select" name="address_lookup" class="css-1utqoku"
value=""></div>
</div>
</div><span aria-hidden="true" data-flux-role="spacer" class="css-1mq8x52"></span><button tabindex="-1" class="fs-unmask css-1he4hdw" type="button" style="font-weight: 600; font-size: 14px;"><span class="css-y6l269">or click here to enter your
address manually</span></button><span aria-hidden="true" data-flux-role="spacer" class="css-1cqmfhn"></span><span aria-hidden="true" data-flux-role="spacer" class="css-yh839r"></span>
<div class="css-z11b9x"><button type="submit" class="fs-unmask css-ks1dz3"><span class="css-y6l269">Continue</span><span class="css-1lwpcs8"><svg width="1em" height="1em" viewBox="0 0 16 16" xmlns="http://www.w3.org/2000/svg" role="img"
fill="currentColor" aria-hidden="true" class="css-5b342m">
<path d="M9.3 1.3 7.9 2.7 12.2 7H0v2h12.2l-4.3 4.3 1.4 1.4L16 8z" fill-rule="evenodd"></path>
</svg></span></button></div>
</form>Text Content
PLEASE ENABLE JAVASCRIPT TO CONTINUE You could also try using another browser with JavaScript enabled. Securely powered by Set up a Direct Debit with NPP Neuro Group Your Direct Debit will be set up now, but we'll confirm the amount and let you know before future payments are taken. Pay with (£) GBP($) USD(kr) SEK($) AUD($) NZD(kr.) DKK($) CAD(€) EUR Country of residence Please select your countryÅland Islands Australia Austria Belgium Canada Cyprus Denmark Estonia Faroe Islands Finland France French Guiana Germany Greece Greenland Guadeloupe Iceland Ireland Italy Latvia Lithuania Luxembourg Malta Martinique Mayotte Monaco Netherlands New Zealand Portugal Réunion Saint Barthélemy Saint Martin Saint Pierre and Miquelon San Marino Slovakia Slovenia Spain Sweden United Kingdom United States YOUR COMPANY DETAILS Company name or click here to use your name Email address We'll only use this to keep you updated about your payment Billing address or click here to enter your address manually Continue Securely powered by andy.chatham@nppneurogroup.com | +44 7969 957554 By confirming you are agreeing to our Website Terms of Use. GoCardless uses personal data as described in our Privacy Notice. We use analytics cookies. Your payments are protected by the Direct Debit Guarantee. GoCardless (company registration number 07495895) is authorised by the Financial Conduct Authority under the Payment Services Regulations 2017, registration number 597190, for the provision of payment services. Have any feedback? GoCardless