<%@LANGUAGE="VBSCRIPT" CODEPAGE="65001"%> <% 'Retrive Dog & Cat breed list from MSDE DB dim oRSBreedListDog dim oRSBreedListCat dim oRSBreedListRab set ahBreedList = server.CreateObject("AC_AH_PREMIUM.cGetPremium") '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 'Retrive Dog breed list from MSDE DB set oRSBreedListDog = server.createobject("ADODB.recordset") set oRSBreedListDog = ahBreedList.GetBreedList(cstr("dog"),cstr("PP")) oRSBreedListDog.MoveFirst 'Retrive Cat breed list from MSDE DB set oRSBreedListCat = server.createobject("ADODB.recordset") set oRSBreedListCat = ahBreedList.GetBreedList(cstr("cat"),cstr("PP")) oRSBreedListCat.MoveFirst 'Retrive Rabbit breed list from MSDE DB set oRSBreedListRab = server.createobject("ADODB.recordset") set oRSBreedListRab = ahBreedList.GetBreedList(cstr("rab"),cstr("PP")) set ahBreedList = nothing oRSBreedListRab.MoveFirst %> Paying by direct debit | Petplan
<% 'Response.CacheControl = "no-cache" 'Response.AddHeader "Pragma", "no-cache" 'Response.Expires = -1 'Create the variables for the sidebars, page id and quotemsg Dim pID, subpID, quoteMsg 'Current page id pID = 5 'Message in the header, leave blank for no quote quoteMsg = "Petplan is a pet insurance specialist, providing insurance for cats, dogs, rabbits and horses. That's why they're called the pet people." Dim iCnt1, iYear, iDay 'select case Request.ServerVariables("local_addr") '' ' case sDevSite '' 'skip ' case sCornhillStagingSite '' 'skip ' case else ' if Request.ServerVariables("HTTPS")="off" then ' strURL="https://"& Request.ServerVariables("HTTP_HOST")& Request.ServerVariables("PATH_INFO") ' if Trim(Request.ServerVariables("QUERY_STRING"))<>"" then ' strURL=strURL & "?" & Request.ServerVariables("QUERY_STRING") ' end if ' Response.Redirect(strURL) ' end if 'end select %>

Your details

Paying for your policy by Direct Debit allows you to spread your premium over the course of the year at no extra cost.

To set this up simply complete the secure form below or download and return this payment form here. The total amount due is shown on your Certificate of Insurance and we will send you a detailed Direct Debit payment schedule by post. If you are having difficulty viewing the PDF file, you may need to download Adobe Reader.

All fields marked * are mandatory.

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There are some problems with your submission, please check the form below for errors and try again.
" data-parsley-generictextminimallettersonly="" title='Please enter your Full Name' placeholder='Full Name' data-parsley-required='true' aria-required='true' maxlength='100' />
Date of Birth *
" type='text' data-parsley-generictextminimalnumberslettersonly='' title='Please enter your Postcode and click "Find Address"' placeholder='Your postcode' maxlength='10' data-parsley-required='true' aria-required='true' />
" />
" type='text' title='Please enter your House name/no' data-parsley-generictext="" placeholder='Enter your House name/no' maxlength='100' data-parsley-required='true' aria-required='true' /> " />
" type='text' title='Please enter your Street' data-parsley-generictext="" placeholder='Enter your Street' maxlength='100' data-parsley-required='true' aria-required='true' />
" type='text' title='Please enter your Town' data-parsley-generictext="" placeholder='Enter your Town' maxlength='100' data-parsley-required='true' aria-required='true' />
" type='text' title='Please enter your County' data-parsley-generictext="" placeholder='Enter your County' maxlength='100' />
" data-parsley-policyno='' type='text' title='Please enter your Policy number' placeholder='Enter Policy Number' data-parsley-minlength='9' maxlength='9' data-parsley-required='true' aria-required='true' />
If you have more than one policy with Petplan you will have to complete this form for each policy.
" data-parsley-generictextminimallettersonly='' title='Please enter your Pets Name' placeholder='Enter pet name' maxlength='100' data-parsley-required='true' aria-required='true' />



 
Policy renewal date *

Direct Debit

Instruction to your bank or building society to pay by Direct Debit.

In order to set up your Direct Debit Instruction online you need to be the holder of a personal account or have a joint account which does not require both account holders to authorise Direct Debits.

Please pay Pet Plan Limited Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with Pet Plan Limited and, if so, details will be passed electronically to my Bank/Building Society.

/ 9 / 2 / 6 / 1 / 3 / 5 /
Branch Sort Code *
" minlength="2" maxlength="2" size='2' title='1' placeholder='00' data-parsley-type='number' />
" minlength="2" maxlength="2" size='2' title='2' placeholder='00' data-parsley-type='number' />
" minlength="2" maxlength="2" size='2' title='3' placeholder='00' data-parsley-type='number' />

Thank you very much for your Direct Debit Instruction details. These can be printed off at the next step and will also be sent to you with your Certificates of Insurance.

Here is the Direct Debit Guarantee for your information.

Direct Debit Guarantee

Direct Debit Guarantee Logo

This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.

If there are any changes to the amount, date, or frequency of your Direct Debit, Pet Plan Limited will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Pet Plan Limited to collect a payment, confirmation of the amount and date will be given to you at the time of the request.

If an error is made in the payment of your Direct Debit, by Pet Plan Limited or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society.

If you receive a refund you are not entitled to, you must pay it back when Pet Plan Limited asks you to.

You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.