I/we, the undersigned, confirm that the account information I have provided is an account in my name. This signed Authority and Mandate refers to our
contract as dated on signature hereof. I/We hereby authorise Triarc to issue and deliver payment instructions to the Bank for collection against my/our
above-mentioned Bank 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 instruction will never exceed my/our obligations as agreed in our contract/agreement 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 to you in writing. The
payment day may be aligned to an earlier salary in December if agreed by you and Triarc.
The individual payment instructions so authorised to be issued must be issued and delivered and will continue monthly from the start date as indicated
above. In the event that the payment day falls on a Sunday, or recognised South African public holiday, the payment day will automatically be the very
next business day. Furthermore, if there are insufficient funds in my account to meet the obligation, you are entitled to track my account and represent
the instruction for payment as soon as sufficient funds are available in my account.
I/we understand that the withdrawals hereby authorised will be processed through a computerised system provided by the South African Banks. I also
understand that details of each withdrawal will be printed on my bank statement. Such must contain a number, which must be included in the said
payment instruction and if provided to me should enable me to identify the Agreement.
I/we acknowledge that all payment instructions issued by you shall be treated by me/our above-mentioned bank as if the instructions had been issued
by me/us personally. I/we agree that although this Authority and Mandate may be cancelled 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I/we shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to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 to 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.
TRIARC is an authorised financial services provider FSP45009. TRIARC insurance products underwritten by Guardrisk Life FSP76. Council of Medical Scheme
Number ORG 4040.