SEPA bankform

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Download the SEPA authorization form


Are you already registered online but do you need a new SEPA authorization? Click on the link below!

English SEPA authorization form
Dutch SEPA authorization form

Both registration form and SEPA authorization can be send to the following address:

Antonius Deusinglaan 1
9713 AV Groningen
t.a.v. Pharmaciae Sacrum