I/We hereby request, instruct and authorize you to draw against my/our account with the above mentioned bank (or any other bank or branch to which I/we may transfer my/our account) a monthly payment of R .

On the day of each and every month commencing on

All such withdrawals from my/our bank account by you shall be treated as though they had been signed by me/us personally.

I/We understand that the withdrawals hereby authorized will be processed by computer through a system provided by the South African Banks, and I also understand that details of each withdrawal will be printed on my bank statement.

I/We agree to pay any bank charges relating to this debit order instruction.

This agreement may be cancelled by me/us by giving you thirty days notice in writing, but I/we understand that I/we shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force if such amounts were legally owing to you.

Receipt of this instruction by you shall be regarded as receipt thereof by my/our bank.

ASSIGNMENT:
I/We acknowledge that the party hereby authorized to effect the drawing/s against my/our account may not cede or assign any of its rights to a third party without my/our prior consent and I/we may not delegate any of my/our obligations in terms of this agreement to any third party without prior written consent of the authorized party.

Signed on this day of

(SIGNATURE AS USED FOR SIGNING CHEQUES)