SERVICE PROVIDER FEE AGREEMENT & CONSUMER MANDATE Given by (Name of account holder) Address Identity Number Contract Number Bank

Contract Sequence Branch code Account number

Account type

Date

To: (Name of beneficiary) Beneficiary's address FIRST DUE DATE

LAST DUE DATE

__/__/2014

__/__/2014

Client Number

00000000

LOANS ACCEPTABLE CC 829 HERTZOG STREET, RIETFONTEIN, PRETORIA, 0084 NUMBBER OF INSTALMENTS

CONTRACT AGREEMENT INSTALLMENT

1

SERVICE PROVIDER FEE (VAT) INCLUSIVE

R349

RECORDED

R7.96

TOTAL TO BE COLLECTED

SERVICE PROVIDER NAME

R356.96

Real Pay

The details of any withdrawal facilitated by

The customer (account holder) has entered into a

Real Pay will be reflected on my bank statement or

contract with the Beneficiary.

a voucher directly after processing.

Real Pay as an approved PASA, and Early Debit

that the withdrawals herby authorised will be processed

I/We understand

Order PSSF, accredited System Operator,

through a computerized system that details of each

originate, submit, issue and deliver payment

withdrawal will be printed on my bank statement or on an

instructions drawn on the bank of the Customer

accompanying voucher.

and as indicated in the PAYMENT SCHEDULE above,

provided to you should enable you to identify

This reference number, if

in favour of the Beneficiary.

the Agreement / Contract.

The customer acknowledge and is aware that the

I / We shall not be entitled to any refund of amounts

customer's bank may charge the customer banking

which you have withdrawn while this authority was in

charges for executing the customers instructions

force, if such amounts were legally owing to you.

which bank charges is not included in the payment schedule

MANDATE

The deduction against the bank account of the

issued by you shall be treated by my/our bank as if

Customer will consist of the amounts in the

the instructions had been issued by me/us personally.

I/We acknowledge that all payment instructions

above PAYMENT SCHEDULE, and will be processed as a single transaction.

CANCELLATION

The customer acknowledge that this mandate and

me/us by giving you notice in writing of not less

This Authority and Mandate may be terminated by authority does not constitute a Credit agreement

20 ordinary working days, and sent by prepaid registered

as contemplated in the

post or delivered to your address as indicated above.

Nation Credit Act 34 of

2005 and the service fee of Real Pay is not

I/We agree that although this Authority and Mandate

included as part of the principle debt or

may be cancelled by me/us, such cancellation will not

deferred amount in any contract between those

cancel the Credit Agreement.

parties.

entitled to any refund of service fees paid in execution

I/We shall not be

of the service. AUTHORITY I/We herby instructed and authorise Real Pay to

ASSIGNMENT

issue and deliver payment instructions to my

In the absence of the credit agreement not being ceded

banker for collection against my/our abovementioned account

this mandate may not be signed to a third party.

at my/our abovementioned bank (or any other bank or

Further such assignment shall only be to

branch to which I/we may transfer my/our account) on

and accredited third party.

condition that the sum of such payment instructions will never exceed my/our obligations as agreed to in the Payment Schedule; In the event that the payment day falls on a Sunday or recognized public holiday, the payment day will automatically be scheduled for the very next ordinary business day. Further, if there are insufficient funds in the nominated account to meet the obligation, you are entitled to track my account and re-present the instruction for payment as soon as sufficient funds are available in my account. Signed at PRETORIA on the

_____ day of _________ 2014

x Customer Signature

Beneficiary Signature (on behalf of Service Provider)