Lenomedia - Debit order mandate


Please fill out the following form

First name  

Last name  

ID Number  

Company Name  

Company Registration Number  


Street address

Address line 2

City

Country

 


Bank Name

Type of Account*

Lenomedia

 

Mandate

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.

 

Cancellation

I/We agree that although this Authority and Mandate may be canceled 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 I/We shall not be entitled to any refund of amounts which you have withdrawn while this Authority was in force, if such amounts were legally owing to you.

 

Assignment

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.

 

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Signature Certificate
Document name: Lenomedia - Debit order mandate
Unique Document ID: be8f8092c8d48cdbdbf6a1b091f7fbf20945eb15
Timestamp Audit
2017-11-09 09:21 SASTLenomedia - Debit order mandate Uploaded by Lenomedia Design Studio - hello@lenomedia.co.za IP 105.184.216.85
2017-11-20 16:13 SAST Document owner hello@lenomedia.co.za has handed over this document to heilene@lenomedia.co.za 2017-11-20 16:13:02 - 105.184.216.5
2017-11-20 16:39 SAST Document owner heilene@lenomedia.co.za has handed over this document to hello@lenomedia.co.za 2017-11-20 16:39:20 - 105.184.216.5
2017-11-20 16:45 SASTGVA Lenomedia - hello@lenomedia.co.za added by Lenomedia Design Studio - hello@lenomedia.co.za as a CC'd Recipient Ip: 105.184.216.5
2017-11-22 10:51 SASTGVA Lenomedia - hello@lenomedia.co.za added by Lenomedia Design Studio - hello@lenomedia.co.za as a CC'd Recipient Ip: 41.13.68.102
2017-11-22 12:45 SASTGVA Lenomedia - hello@lenomedia.co.za added by Lenomedia Design Studio - hello@lenomedia.co.za as a CC'd Recipient Ip: 41.13.116.7
2017-12-07 09:28 SASTGVA Lenomedia - hello@lenomedia.co.za added by Lenomedia Design Studio - hello@lenomedia.co.za as a CC'd Recipient Ip: 105.184.170.59
2018-08-15 13:36 SASTGVA Lenomedia - hello@lenomedia.co.za added by Lenomedia Design Studio - hello@lenomedia.co.za as a CC'd Recipient Ip: 105.184.216.85