This signed Authority and Mandate refers to our contract dated

(“the Agreement”)


I/We hereby authorise you to issue and deliver payment instructions to your Banker for collection against my/our abovementioned 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 is terminated by me/us by giving you notice in writing of not less 20 ordinary working days, and sent by prepaid registered post or delivered to your address indicated above.

The individual payment instructions so authorised to be issued must be issued and delivered as follows:

i. on the _ day (“payment day”) of the month commencing on




In the event that the payment day falls on a Sunday or recognized public holiday, the payment day will automatically be the very next ordinary business day.
Furthermore, if there are insufficient funds in the (my) nominated account to meet the obligation, you are entitled to track my account and re-present the instruction for payment as soon as sufficient funds are available in my account;
Digitally signed at (place)


I hereby give permission to debit my account.