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Details for Compliments Slip


Company (Firm) Name: » 
SAICA Membership Number: » 
Postal Address: » 
Postal Code: » 
Physical Address:  
Postal Code:  
Telephone No.: »   
Fax No.:    
E-mail: » 
Web site:  
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(if any, max 255 characters)
 

Contact Person

Please designate a contact person within the firm:

First name: » 
Last name: » 
Telephone No.: »   
Fax No.:    
E-mail: » 

Tax Invoices

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Debit Order Instruction

The details of my/our bank account are as follows:

Bank: » 
Branch Name: » 
Branch Code: » 
Account No.: » 
Account Type: » 
 

I/We hereby request, instruct and authorize you to draw against my/our account with the abovementioned bank (or any other bank or branch to which I/We may transfer my/our account) the amounts necessary for payment of our monthly subscription fees in respect of the this agreement commencing on 1st . All such withdrawals from my/our bank account by you shall be treated as though they had been signed by me/us personally.

I/We understand that the withdrawals hereby authorised will be processed through a computerised system provided by the South African Banks and I also understand that details of each withdrawal will be printed on my bank statement or on an accompanying voucher.

I/We agree to pay any bank charges relating to this debit order instruction.

This authority may be cancelled by me/us by giving you thirty days notice in writing, sent by prepaid registered post, but I/we understand that I/we shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you.

ASSIGNMENT

I/We acknowledge that the party hereby authorised to effect the drawing(s) against my/our account may not cede or assign any of its rights to any third party without my/our prior written consent and that I/we may not delegate any of my/our obligations in terms of this contract/authority to any third party without prior written consent of the authorised party.

Receipt of this instruction by you shall be regarded as receipt thereof by my/our bank (whichever it is or will be).

I hereby agree to the terms above and confirm that I have read and acknowledged the
Terms and Conditions: