You hereby authorise and instruct us to issue and deliver payment
instructions to your bank for the collection against your nominated
account (or any other bank or branch to which you may transfer your
account) the amount necessary for payment of the monthly premium due
in respect of our agreement, on the day nominated by you, each and
every month and continuing until cancellation of your agreement or
until cancelled by you in accordance with Section C below.
The withdrawals will be processed through a computerised system
provided by the South African Banks and that details of each
withdrawal will be printed on my bank statement.
All payment instructions issued by us will be treated by your bank
as though the instructions had been authorised by you personally.
You agree to pay all bank charges relating to this debit order
instruction and mandate.
This authority and mandate may be cancelled by you, such
cancellation will not cancel our agreement.
Any notice of cancellation by you must be provided in writing of no
less than the period stated in the termination/cancellation clause
in our agreement and must sent by email to firstname.lastname@example.org or
delivered to our address indicated in our agreement.
If this instruction and mandate is cancelled by you, then you
understand that you shall not be entitled to any refund of amounts
which we have withdrawn while this authority was in force, if such
amounts were legally owing to us.
You acknowledge that this authority and mandate may be ceded or
assigned to a third party if your agreement with us is also ceded or
assigned to that third party, but in the absence of such assignment
of our agreement, this authority and mandate cannot be assigned to
any third party.
AGREEMENT REFERENCE NUMBER
This agreement reference number is N/A
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