Request for Direct Credit   
VAT No:     
PIN Number
Account Holder Name   (Name and Surname Format) Click for Help  
International Bank Account Number (IBAN) Click for Help    
Bank Identifier Code (BIC) Click for Help    
Email Address    
Mobile Number  
I hereby declare that all the information given above is, to my knowledge, true, complete and correct. I understand that if any of the above information is incorrect or given with the intention to defraud, I shall be liable to charges in terms of the provision of the Criminal Code (Chapter 9 of the Laws of Malta);

I hereby agree that if there were to be any changes to the account number provided above, I shall immediately inform the Commissioner for Revenue;

I hereby authorise the Commissioner for Revenue to verify with the above details.