MAXIMUM RISK PROTECTION - Country wide Service
DEBIT ORDER AUTHORIZATION
 Maximum Risk Protection FIN-DOC-001
  Compiler:   Member  J.J Swarts Rev (Amdt) No: 6
  Approving Officer:  Member  J.J Swarts Effective Date: 21/01/2014

CLIENT ACCOUNT CODE : 
FIRST NAMES :  
SURNAME / BUSINESS NAME :  
STREET ADDRESS : 

I/We, the undersigned, hereby authorize Riant Investments 101cc T/A Maximum Risk Protection to debit my/our account with the Financial Institution mentioned, or any other Financial Institution to which my/our account may be transferred, with the monies due in respect of the security service rendered and or any outstanding monies due to Riant Investments 101cc and I/We authorize the said Financial Institution to pay such amounts to Riant Investments 101c.c. I/We agree that this authority shall remain in force until cancelled by me/us in writing to Riant Investments 101c.c.

I/We acknowledge that the party hereby authorized 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 authorized party.

I/We agree that Riant Investments 101c.c. shall be entitled to debit my/our account at any time but I/We would prefer to have my/our account debited on the .

Type of account :    Amount : R  
First deduction will be on:

FINANCIAL INSTITUTION
Name of Bank / Financial Institution:  
8 Digit Bank Code:  City/Town :
Branch where account is kept:
Account Number:  
Name of Account Holder:

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I agree to the contents of the document without applying my signature to it.
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