Debit Order Mandate

Authorisation given by (name of Accountholder):  

bitCONNECT account code:  



Branch and Code:  

Account Number:  

Type of Account:   

Amount to be debited:  Full balance owing as per statement

Debit Date:  

Contact Name:  

Contact Number:

Abbreviated Name as Registered with the Bank: Bitconnect  

The abbreviated name will be displayed on your bank statement.       


This signed Authority and Mandate refers to our contract dated (“the Agreement”).

I/We hereby authorise you to issue and deliver payment instructions to your Banker for collection against my/our above-mentioned account at my/our above-mentioned 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 agreed to in the Agreement and commencing on and continuing until this Authority and Mandate is terminated by me/us by giving you notice in writing of not less than 20 ordinary working days, and sent by prepaid registered post or delivered to your address as indicated above.

The individual payment instructions so authorised to be issued must be issued and delivered as follows: monthly

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

Payment Instructions due in December may be debited against my account on the day of the month as selected.

I / We understand that the withdrawals hereby authorized will be processed through a computerized system provided by the South African Banks and I also understand that details of each withdrawal will be printed on my bank statement. Each transaction will contain a number, which must be included in the said payment instruction and if provided to you should enable you to identify the Agreement. A payment reference is added to this form before the issuing of any payment instruction.


I/We acknowledge that all payment instructions issued by you shall be treated by my/our above-mentioned Bank as if the instructions have 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 Agreement. I/We shall not be entitled to any refund of amounts which you have withdrawn while this Authority was in force, if such amounts were legally owing to you.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.


Assisted by Lionel Redelinghuys

Agreement reference number is
Applicable only to existing clients 

Leave this empty:

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Signed by Lionel Redelinghuys
Signed On: August 18, 2020

Signature Certificate
Document name: Debit Order Mandate
lock iconUnique Document ID: f1c9f4415ffa7690ba3cdf526f42bcfc20c9e50f
Timestamp Audit
July 16, 2020 2:13 pm SASTDebit Order Mandate Uploaded by Lionel Redelinghuys - IP