Confirmation

You_Have_Been_Selected!

Et hekwini Revenue Managem ent Florence Mkhize Building 251 Anton Lembede Street Durban 4001 Tel: 031 311 1363/67 Fax: 031 311 1116 E - Mail: revline@durban.gov.za Website: http://www.durban.gov.za NOTIFICATION OF CHANGE DIRECT DEBIT DETAILS PARTICULARS OF CUSTOMER METRO BILL ACCOUNT REFERENCE: _________________________________________________________________ _ SURNAME & INITIALS: _________________________________________________________________ _ ADDRESS: ______ ___________________________________________________________ _ ____________________________________________ CODE: _______________ ID NO: _________________________________________________________________ _ TELEPHONE (B): ___________________________ ____ TELEPHONE (H): ___________________________________________ _ I hereby notify Et hekwini Municipality of the following changes to my Debit Order: (Indicate what changes you want to make by ticking the appropriate box) Increase Direct Debit Limit, from R __________ ___ to R ____________ Decrease Direct Debit Limit, from R _________ ___ to R ____________ Change of Banking Details as indicated below Cancel Direct debit Order wit h effect from ______________________________ 20 1 _ BANK ACCOUNT DETAILS : NAME OF BANK: ____________________ BANK ACCOUNT NO: _________________________ BRANCH CODE _________ _ ACCOUNT TYPE: (X the appropriate box) NAME & INITIALS OF ACC OUNT HOLDER : _________________________________________________________________ _ PLEASE RETURN THIS FORM TOGETHER WITH A BANK STATEMENT ________________________ ____________________________ ____ _________________________ _ ACCOUN T HOLDER SIGNATURE or REPRESENTATIVE SIGNATURE ____________________________ DATE CONDITIONS I understand and accept the following conditions of authorization: 1. Should the above limit be insufficient to settle my bill, I undertake to pay the diffe rence in cash or via electronic transfer. 2. I undertake to maintain the above limit at a realistic level at all times. 3. The Council may cancel the debit order should my bank disallow a debit against my account on two occasions due to insufficien t funds, or an y other reason. 4. This authorization will remain in operation until revoked by me, by giving 30 days prior written notice to this effect or due to transfer or termination of services, or changes in bank details or for any other reason. 5. If my bank rejects an y debit against my account for lack of funds or any other reason, I undertake to pay the Council a penalty in respect of each such rejection, which amount will be added to my Metro bill, and the amount of such penalty may be varied from time to time in acc ordance with the City's by - laws and tariffs . A disconnection order will be issued without notice if there is a rejection of the debit order. 6. I authorise the Council to adjust the above limit automatically whenever there is a tariff increase with a percenta ge equal to such an adjustment, or if the limit is insufficient to settle the bill. 7. Funds should be available at least 24 hours before direct debit due date. 8. No written notification will be given if the bank returns a debit order. I undertake to contact th is office immediately should there be a rejection reflected on my bill. 9. ASSIGNMENT: I / We acknowledge that the party hereby authorized to effect the drawing(s) against my/our account may not cede or assign an y 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 to any third party. PLEASE COMPLETE IN BLOCK LETTERS CHEQUE SAVINGS TRANSMISSION ------ZAzi9PPy6vyAjsMgX9kz Content-Type: audio/basic Content-Description: Parker re: budget (audio) ------ZAzi9PPy6vyAjsMgX9kz--