DevelopCore: Electronic Debit Order Agreement

Electronic debit order agreement

Application Type*
Signed up by branch
Affiliate Code
Business Name*
Trading As
If applicable
Business Registration Number*
Annual Payroll Scale*
How many Employees do you have?*
Contact Person*
First Last
Contact Identification Type*
- RSA ID
- Passport
Contact Person ID Number*
Contact Person Passport Number*
Position Held in Business
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Tel Number*
Cell Number*
Email Address*
Type of Business
VAT Number
Bank Account Details:
Please provide your bank account information.
Account Holder*
Bank*
Branch Code*
Account Number*
Account Type*
Agreement:
Service*
Contract Reference*
Once-off Amount
Recurring Amount*
I/we agree that the first payment instruction will be issued and delivered on:
Start Date*
Date Format: YYYY dash MM dash DD
and thereafter regularly on the:
Debit Day
Debit Order Terms*
Abbreviated short name as registered with the acquiring bank: DEVELOPCOR
I/We hereby authorise Developcore (Pty) Ltd to issue and deliver payment instructions to your Banker for collection against my/our above-mentioned account at my/our above-mentioned Bank (or any other bank or branch to which I/we may transfer my/our account) on condition that the sum of such payment instructions will never exceed my/our obligations as agreed to in the Agreement and commencing on and continuing until this Authority and Mandate are terminated by me/us by giving you one calendar’s month notice in writing at least one (1) month before the anniversary of the agreement.
The individual payment instructions so authorised to be issued must be issued and delivered monthly (on the first day of every month).
In the event that the payment day falls on a Sunday, or recognised South African public holiday, the payment day will automatically be the very next ordinary business day.
I/We understand that the withdrawals hereby authorised will be processed through a computerized system provided by the South African Banks. I also understand that details of each debit order will be printed on my bank statement. This statement reference must contain a number, which must be included in the said payment instruction and if provided to Developcore should enable Developcore to identify your agreement. This number must be added to this form in “The Agreement reference” field below, before the issuing of any payment instruction.
B. Mandate
I/We acknowledge that all payment instructions issued by you shall be treated by my/our abovementioned Bank as if the instructions have been issued by me/us personally.
I/We acknowledge that if the amount of the debit order needs to be amended (due to insufficient funds or any other reason) and/or if the reference name of the payment is changed, then Developcore may debit from the account listed, on any date it may decide at its own discretion, to settle the amount owed to Developcore for any reason whatsoever.
C. Cancellation
I/We agree that although this Authority and Mandate may be cancelled by me/us, such cancellation will not cancel the Agreement. 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.
D. Assignment
I/We acknowledge that this Authority may be ceded or assigned to a third party if the Agreement is also ceded or assigned to that third party, but in the absence of a written assignment of the Agreement, this Authority and Mandate may not be assigned to any third party.
- I agree to the Debit Order Terms above and the Terms of Agreement.
Signature*
Signature verified by Bank
Email
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E-Mandate

Electronic debit order mandates for your business.

(DD) #82 DC001 – DevelopCore

Bank Account Details:

Agreement: