(DD) #** LPS001 – Lilianton Security & Patrol NPC Electronic debit order mandate Authority given by:Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email Address* Contact Number*Bank account details:Account Holder*Bank*ABSA BANKCAPITEC BANK LIMITEDFIRST NATIONAL BANKFIRSTRAND BANKINVESTEC BANK LIMITEDNEDBANKSTANDARD BANKABSA-ITHALAAFRICAN BANKALBARAKA BANKBANK OF ATHENSBANK WINDHOEK BEPERKBIDVEST BANK LIMITEDCITIBANKDISCOVERY BANK LTDFBC FIDELITY BANK LTDGRINDROD BANK LIMITEDHABIB OVERSEAS BANK LIMITEDHBZ BANK LIMITEDHONGKONG & SHANGHAI BANKINGHSBC BANKOM BANK LIMITEDCAPITEC BUSINESSMTN BANKING(STANDARD BANK)NEDBANK LESOTHO LIMITEDNEDBANK LTD INC BOE BANKNEDBANK NAMIBIANEDBANK SWAZILAND LIMITEDPEOPLE BANK LTD INC PEP BANKPEOPLES BANK LTD INC NBSPERMANENT BANKSA POST BANK (POST OFFICE)SA BANK OF ATHENSSA RESERVESASFIN BANKSOCIETE GENERAL JHB BRANCHSOUTH AFRICAN POST OFFICESTANDARD BANK SWAZILANDSTANDARD CHARTERED BANK SASTANDARD LESOTHO BANK LTDSTATE BANK OF INDIASWAZILAND DEV AND SAVINGS BANKTHE ROYAL BANK OF SCOTLAND N.VTYME BANK LIMITEDUBANK LTDVBS MUTUAL BANKFINBOND MUTUAL BANKACCESS BANKBANK OF CHINABANK ZEROBNP PARIBAS SA SOUTH AFRICACHINA CONSTRUCTION BANKFINBOND NET1ICICI BANK LIMITEDJ.P.MORGAN CHASE BANK N.ASOCIETE GENERALEBranch Code*Account Number*Account Type*Current (Cheque)SavingsTransmissionAgreement:Contract Reference*Contract Amount*Please enter a number less than or equal to 550.I/we agree that the first payment instruction will be issued and delivered on:Start Date* Date Format: DD slash MM slash YYYY and thereafter regularly on the:Debit Day*1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th15th16th17th18th19th20th21st22nd23rd24th25th26th27th28th29th30th31stTerms of agreementAbbreviated short name as registered with the acquiring bank: LSP NPO Refer to our contract reference number (“the Contract Reference Number”). I/We hereby authorise Lilianton Security & Patrol NPC to issue and deliver payment instructions to your banker for collection against my/our abovementioned account at my/our abovementioned bank on condition that the sum of such payment instructions will not differ from my/our obligations as agreed to in the Contract Reference Number. The individual payment instructions so authorised must be issued and delivered on the date when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not differ as agreed to in terms of the Agreement. I/We agree that the first payment instruction will be issued and delivered on the "Start Date" and thereafter regularly on the "Action Day" of each month. If however, the date of the payment instruction falls on a non-processing day (weekend or public holiday) I agree that the payment instruction may be debited against my account on the following business day; or subsequent payment instructions will continue to be delivered in terms of this authority until the obligations in terms of the Agreement have been paid or until this authority is cancelled by me/us by giving you notice in writing of not less than the interval (as indicated in the previous clause) and sent by prepaid registered post or delivered to your address indicated above. I/We allow for tracking of dates to match with the flow of credit at no additional cost to myself. A monthly invoice and/or statement of account clearly reflecting the amount and date of the payment instruction to be delivered shall be provided to the customer. Mandate I/We acknowledge that all payment instructions issued by you shall be treated by my/our above-mentioned bank as if the instructions had been issued by me/us personally. 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 also understand that I/we cannot reclaim amounts, which have been withdrawn from my/our account (paid) in terms of this authority and mandate if such amounts were legally owing to you. 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.Terms and conditionsI/We, the Owner(s)/Occupier(s)/Tenant(s), hereby bind ourselves to the following terms and conditions: 1. MEMBERSHIP Upon execution of this agreement by the undersigned party(ies), I/we shall become a member(s) of LILIANTON SECURITY AND PATROL NPC. 2. LEVY PAYMENTS I/we undertake to pay all levies and any additional charges duly approved by the NPC, effective from the date of signature of this agreement, which amount is payable by no later than the 7 th day of each month, with the first payment to be on the 7 th day of the month following the date of signature hereof. 3. LEVY AMOUNT AND ANNUAL ADJUSTMENTS As at date of signature of this agreement, the current monthly levy is R 550.00 (five hundred and fifty rand). This amount shall increase annually by 7%, effective on the 1st of May each year, irrespective of the date on which this agreement was signed. 4. NON-PAYMENT AND DIRECTOR DISCRETION In the event that I/we am/are unable to make payment of the prescribed levy, the Directors of the NPC shall first engage with the owner, occupier, or tenant to determine whether the inability to pay is due to affordability constraints or any other reason. The Directors shall have the sole discretion to suspend / amend / reduce the levy obligations for a period they deem appropriate. 5. LEGAL ACTION FOR NON-COMPLIANCE Should it be determined that the levy payment is feasible but remains unpaid, the Directors shall refer the matter to the legal representatives acting on behalf of LILIANTON SECURITY AND PATROL NPC for the due collection of area levies. I/we expressly agree to indemnify and reimburse LILIANTON SECURITY AND PATROL NPC for any and all legal costs incurred in enforcing compliance with this agreement. Such costs shall be calculated on an attorney-and-client scale, including collection commission, disbursements, and any other expenses reasonably incurred. The NPC shall have the authority to charge my levy account with said legal costs. 6. DETERMINATION OF ANNUAL LEVIES AND INCREASES I / we agree and consent and agree that the annual levies and annual increase may be amended from time to time at the annual general meeting of the NPC, which decision shall be binding upon me upon the provision that such decision was lawfully obtained in terms of the MOI of the NPC or the Companies Act. 7. TERMINATION OF THIS AGREEMENT The enforceability of the agreement against the signatory(ies) hereof will cease in it’s entirety as from date such person(s) is / are no longer and owner / resident / tenant of the property indicated on the cover page hereof. Any arrears due and payable until date of termination of this agreement in terms hereof shall remain due and payable to the LILIANTON SECURITY AND PATROL NPCSignature*Signature verified by BankSource