Debit Order Form Please complete this Debit Order Instruction in order to activate the service. DEBIT ORDER INSTRUCTIONto LABOURWISE (Pty) Ltd, P O Box 391, Somerset West 7129Company Name/Debtor *Company VAT Registration number *Contact Number *Email Address *Postal Address *The description of services on the LABOURWISE cost/benefits page refers.MY BANK DETAILSBank *Branch name & town *Branch code *Account No *Account TypePlease selectCurrent/ChequeSavingsTransmissionI/We hereby request, ”instruct” and authorise you to draw against my/our account with the bank referred to above (or any other bank or branch to which I/we may transfer my/our account) the monthly subscription fee (plus VAT) of:No of employees *Please select1-10 / R29011-50 / R40551-100 / R580101-150 / R795Amount quotedDate of first deduction *and a once-off joining fee (plus VAT) equivalent to the monthly rate must be drawn as from the same date and monthly thereafter, on the 1st day of each and every month, or as soon thereafter as possible, and will continue until cancelled as envisaged below. All such withdrawals from my/our bank account by you shall be treated as though they had been signed by me/us personally. The subscription fee may be increased annually at the end of February every year, but will not exceed 10% of the above amount unless otherwise agreed. I understand that details of each withdrawal will be printed on my bank statement or on an accompanying voucher. I/We agree to pay any bank charges pertaining to this debit order instruction. This authority may be cancelled by me/us by giving you three calendar months’ notice in writing by sending an email to admin@labourwise.co.za. I/we understand that I/we shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force if such amounts were legally owing to you. Receipt of this instruction by you shall be regarded as receipt thereof by my/our bank (whichever it is or will be). ASSIGNMENT: I/We acknowledge that the party hereby authorised to effect the drawing(s) against my/our account may not cede or assign any of its rights to any third party without my/our prior written consent and that I/we may not delegate any of my/our obligations in terms of this contract/authority to any third party without prior written consent of the authorised party.Signed at *Date today *Name in full of authorised person *SEND DEBIT ORDER INSTRUCTIONPlease do not fill in this field.