Please note that if you would like to submit an application for a group policy, contact our Customer Care Department on0860 633 929 or at firstname.lastname@example.org
I hereby authorise you to issue and deliver payment instructions to your banker for collection against my above-mentioned account at my above-mentioned Bank (or any other Bank or branch to which I may transfer my account) on condition that the sum of such payment instructions will never exceed my obligations as agreed to in the Agreement and commencing on the date of debit order above and continuing until this Authority and Mandate is terminated by me by giving you notice in writing of not less then 30 days and sent electronically or by post to the address as indicated above. The individual payment instructions so authorised to be issued must be issued and delivered MONTHLY. In the event that the payment day falls on a Sunday, or a recognised South African public holiday, the payment day will automatically be the very next ordinary business day. I understand that the withdrawals hereby authorised will be processed through a computerised system provided by South African Banks. I also understand the details of each withdrawal will be printed on my Bank statement and will contain a number that enables me to identify the Agreement.
I acknowledge that all payment instructions issued by you shall be treated by my Bank as if the instructions have been issued by me personally.
I agree that although this Authority and Mandate may be cancelled by me, such cancellation will not cancel the Agreement. I shall not be entitled to any refund of amounts which you have withdrawn while this Authority was in force, if such amounts were legally owing to you.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 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 furthermore agree to advise Medway of any changes to the above banking details.
I accept this declaration
I accept the declaration
Click here to read the Statutory Disclosure