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Credit Card Details:
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Direct Debit Details:
CONDITIONS OF THIS AUTHORITY TO ACCEPT DIRECT DEBITS 1. The Initiator: (a) The Initiator undertakes to give notice to the Acceptor of the commencement date, frequency and amount at least 10 calendar days before the first Direct Debit is drawn (but not more than 2 calendar months). This notice will be provided either: (i) in writing: or (ii) by electronic mail where the Customer has provided prior written consent to the Initiator. Where the Direct Debit system is used for the collection of payments which are regular as to frequency, but variable as to amounts, the Initiator undertakes to provide the acceptor with a schedule detailing each payment amount and each payment date. In the event of any subsequent change to the frequency or amount of the Direct Debits, the Initiator has agreed to give advance notice at least 30 days before the change comes into effect. (b) May, upon the relationship which gives rise to this Authority being terminated, give notice to the Bank that no further Direct Debits are to be initiated under the Authority. Upon receipt of such notice the Bank may terminate this Authority as to future payments by notice in writing to me/us. 2. The Customer may: (a) At any time, terminate this Authority as to future payments by giving written notice of termination to the Bank and to the Initiator. (b) Stop payment of any Direct Debit to be initiated under this Authority by the Initiator by giving written notice to the Bank prior to the Direct Debit being paid by the Bank. (c) Where a variation to the amount agreed between the Initiator and the Customer from time to time to be direct debited has been made without notice being given in terms of clause 1(a) above, request the Bank to reverse or alter any such Direct Debit initiated by the Initiator, by debiting the amount of the reversal or alteration of a Direct Debit back to the Initiator through the Initiator's Bank PROVIDED such request is made not more than 120 days from the date when the Direct Debit was debited to my/our account. 3. The Customer acknowledges that: (a) This Authority will remain in full force and effect in respect of all Direct Debits passed to my/our account in good faith notwithstanding my/our death, bankruptcy or other revocation of this Authority until actual notice of such event is received by the Bank. (b) In any event this Authority is subject to any arrangement now or hereafter existing between me/us and the Bank in relation to my/our account. (c) Any dispute as to the correctness or validity of an amount debited to my/our account shall not be the concern of the Bank except in so far as the Direct Debit has not been paid in accordance with this Authority. Any other disputes lie between me/us and the Initiator. (d) Where the Bank has used reasonable care and skill in acting in accordance with this Authority, the Bank accepts no responsibility or liability in respect of: - the accuracy of information about Direct Debits on Bank statements. - any variations between notices given by the Initiator and the amounts of Direct Debits. (e) The Bank is not responsible for, or under any liability in respect of the Initiators failure to give written advance notice correctly nor for the non-receipt or late receipt of notice by me/us for any reason whatsoever. In any situation the dispute lies between me/us and the Initiator. (f) Notice given by the Initiator in terms of clause 1(a) to the debtor responsible for the payments shall be effective. Any communication necessary because the debtor responsible for the payment is a person other than me/us is a matter between me/us and the debtor concerned. 4. The Bank may: (a) In its absolute discretion conclusively determine the order of priority of payment by it of any monies pursuant to this or any other Authority, cheque or draft properly executed by me/us and given to or drawn on the Bank. (b) At any time terminate this Authority as to future payments by notice in writing to me/us. (c) Charge its current fees for this service on force from time to time. Privacy Statement By completing this form: I acknowledge that the information will be provided to <Company / Organisation Name>, Flo2Cash and their nominated call centre, and the nominated bank. I agree that <Company / Organisation Name>, the Flo2Cash may retain this information for the purposes of effecting the donations pledged, and their nominated call centre will retain this information to continue and improve their fundraising activities. My authorisation for <Company / Organisation Name> to debit the specified amount from my credit card account monthly will continue after the expiry date of the credit card and with the issuance of a new card until further notice. I understand that I am entitled to access and request correction of any personal information that <Company / Organisation Name> holds about me.
I agree to the Terms & Conditions.
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