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1. Account Holder Information: Essential details of the account holder including full name, ID number, contact details, and address as required by FICA regulations
2. Bank Account Details: Complete banking information including bank name, account number, branch code, account type, and branch name
3. Authorization Details: Specific details about the authorized debit including payment amount (fixed or variable), collection date, and frequency of collection
4. Beneficiary Information: Details of the company/entity being authorized to collect the funds, including registration number and contact information
5. Terms and Conditions: Standard terms governing the EFT authorization, including cancellation procedures, dispute resolution, and processing timeframes
6. Declaration: Statement confirming the accuracy of information provided and agreement to the terms and conditions
7. Authorization Signature: Space for account holder's signature, date, and witness signatures if required
1. Multiple Account Authorization: Additional section for authorizing collections from multiple bank accounts, used when the account holder wants to split payments across accounts
2. Variable Amount Declaration: Special terms and acknowledgments for variable amount deductions, required when the collection amount may vary month to month
3. Company Resolution: Required for corporate account holders, including resolution details authorizing specific individuals to sign the form
4. Escalation Clause: Optional section specifying automatic annual increases in deduction amounts, used for recurring service contracts
1. Schedule A: Payment Schedule: Detailed breakdown of payment dates, amounts, and frequency if multiple or recurring payments are involved
2. Appendix 1: Required Supporting Documents: Checklist of required supporting documents such as ID copy, proof of banking details, etc.
3. Appendix 2: Bank Account Verification: Bank account verification form or recent bank statement to confirm account details
Authority/Mandate
Bank Account
Beneficiary
Branch Code
Business Day
Collecting Entity
Collection Date
Debit Order
EFT
Electronic Funds Transfer
FICA
Instruction
Mandate
National Payment System
Payment
Payment Date
Payment Instruction
Personal Information
Processing
Reference Number
Service Provider
Settlement Date
Stop Order
Transaction
Variable Amount
Verification
Working Day
Payment Terms
Account Details
Data Protection
Consent
Modification
Cancellation
Dispute Resolution
Indemnification
Amendment
Verification
Processing Terms
Notice Requirements
Termination
Confidentiality
Force Majeure
Governing Law
Consumer Protection
Record Keeping
Variable Amounts
Bank Mandate
Signature Authority
Banking and Financial Services
Insurance
Telecommunications
Utilities
Real Estate
Education
Healthcare
Retail
Professional Services
Non-Profit Organizations
Property Management
Subscription Services
Finance
Legal
Compliance
Operations
Accounts Receivable
Treasury
Customer Service
Sales Administration
Credit Control
Payment Processing
Banking Operations
Financial Manager
Accounts Receivable Manager
Compliance Officer
Legal Counsel
Banking Operations Manager
Credit Controller
Financial Controller
Treasury Manager
Account Manager
Collections Specialist
Payment Operations Manager
Customer Service Manager
Sales Administrator
Billing Coordinator
Finance Director
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