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1. Form Title and Reference Number: Clear identification of the document as a Direct Payment Form with a unique reference number
2. Payer Information: Full details of the person/entity making the payment, including legal name, registration/ID number, and contact details
3. Bank Account Details: Payer's bank account information including account holder name, bank name, branch code, and account number
4. Payment Details: Specification of payment amount, frequency (once-off or recurring), and payment date(s)
5. Beneficiary Information: Full details of the payment recipient, including account holder name, bank name, branch code, and account number
6. Authorization Declaration: Clear statement authorizing the payment and confirming the accuracy of provided information
7. Terms and Conditions: Essential terms governing the payment arrangement, including processing times and responsibilities
8. Signature Section: Space for date, signature, and name of authorized signatory
1. Third Party Authorization: Additional section when payment is being authorized on behalf of another person or entity
2. Multiple Beneficiary Schedule: Used when payments are to be made to multiple beneficiaries
3. Payment Notification Details: Optional section for specifying how payment notifications should be handled
4. Cancellation Terms: Required for recurring payments to specify how the payment instruction can be cancelled
5. VAT Information: Required when the payment relates to VAT-registered entities and tax invoices
6. Reference Information: Optional section for specific payment references or codes required by the beneficiary
1. Schedule A - Supporting Documentation Checklist: List of required supporting documents (e.g., ID copies, proof of bank account) as per FICA requirements
2. Schedule B - Fee Schedule: If applicable, breakdown of any processing fees or charges associated with the payment
3. Schedule C - Multiple Payment Schedule: For recurring payments, detailed schedule of payment dates and amounts
4. Appendix 1 - Bank Terms and Conditions: Standard bank terms and conditions applicable to direct payments
Authorised Signatory
Bank Account
Banking Day
Beneficiary
Branch Code
Commencement Date
Cut-off Time
Debit Date
Direct Payment
Electronic Funds Transfer
FICA
Financial Institution
Instruction
Once-off Payment
Payment Amount
Payment Reference
Recurring Payment
Service Fees
Stop Order
Terms and Conditions
Third Party
Transaction
VAT
Payment Terms
Bank Account Details
Processing Times
Data Protection
Fees and Charges
Amendment
Cancellation
Liability
Force Majeure
Dispute Resolution
Governing Law
Personal Information Protection
Anti-Money Laundering
Electronic Communications
Notification Requirements
Service Level Standards
Verification and Authentication
Banking and Financial Services
Retail
Insurance
Real Estate
Professional Services
Manufacturing
Education
Healthcare
Telecommunications
Utilities
Non-Profit Organizations
Government Services
Finance
Accounts Payable
Treasury
Procurement
Payroll
Compliance
Legal
Banking Operations
Risk Management
Administrative Support
Financial Manager
Accounts Payable Manager
Treasury Manager
Finance Director
Accountant
Financial Controller
Compliance Officer
Banking Relations Manager
Procurement Manager
Payroll Manager
Chief Financial Officer
Financial Administrator
Account Executive
Banking Operations Manager
Risk Manager
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