Authorise Debt Order
Full Name:*
Email Address:*
Verify Email Address:*
ID Number:*
Physical Address:
Postal Address:
Contact Number:*
Reference Number:*
* Mandatory  

Banking Details  
Account Number:
Debit Order Day/Day of the Week:
Bank: (RSA Only)

I/We hereby authorise Credit Intelligence (Pty) Ltd to issue and deliver payment instructions to your bank for collection against my/our abovementioned account at my/our abovementioned 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 in the original debt plus legislated fees, commencing on the next day selected above and continuing monthly 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.

In the event that the payment day falls on a Sunday or recognized South African public holiday, the payment day will automatically be the preceding ordinary business day.

I /We understand that the withdrawals hereby authorised will be processed through a computerised system provided by the South African Banks.

I also understand that details of each withdrawal will be printed on my bank statement marked PM8@CENTRI.

I/We acknowledge that all payment instructions issued by you shall be treated by my/our above-mentioned bank as if the instructions had been issued by me/us personally.

I/We agree that although this Authority and Mandate may be cancelled by me/us, such cancellation will not cancel the original debt or legislated fees.

I/We shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you.

I/We acknowledge that this authority may be ceded or assigned to a third party if the Agreement is also ceded or assigned to that third party, but in the absence of such assignment of the Agreement, this Authority and Mandate cannot be assigned to any third party.

        I hereby accept the above terms.