MY012492
D.R. Lamprecht t/a
www.AttorneysDirectory.co.za
BANK DEBIT ORDER INSTRUCTION
Client’s Name: ______________________________________________________ (Firm)
Address: _______________________________________________________________
Monthly Debit Amount: R______.00 Term: _______ Monthly Cycle
Dear Mr D.R. Lamprecht,
My/our Bank Details are as follows:
Account Name: ___________________________________________________________
Bank: _______________________ Account Number: ____________________________
Branch Number: _________________ Account Type: ___________________________
I hereby authorize you to debit my/our account with the above mentioned banking details with the sum of R__________, on the last working day of the calendar month following the date of signature hereof, and thereafter on the last working day of each successive month, this sum being the amount for settlement of the monthly hosting fees due to you for hosting our advert on www.attorneysdirectory.co.za, in respect of the specific month.
I hereby authorize your agent MyGate Communications (Pty) Ltd to debit my/our account on your behalf. This debit order agreement may be cancelled by giving 1 calendar month’s written notice by e-mail to
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or by fax to 086 696 0601. I understand that the above monthly payments withdrawn prior to such cancellation, while this agreement was still in force, is owed and will not be refunded.
I hereby agree that the party hereby authorized to debit my/our bank account may not cede or assign any of its rights to any third party without my/our prior written consent and that I/we may not cede any of my/our obligations in terms of this debit order instruction to any third party without prior written consent from an AttorneysDirectory representative.
Signature: ________________________ Date ____ day of __________ 2014
Full Name: _______________________ Firm: _______________________