Cedrus Internet Solutions (Pty) Ltd.
P O Box 1091
Hilton 3245
Tel: +27 (0)860 836 337
Fax: 033-3435882/53

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From:
 To: Cedrus Internet Solutions (Pty) Ltd.
Date: __/__/20__

Company name:______________________________ E-mail Address: _______________________________

Postal Address: _______________________________________________________ Contact Person: __________________

Telephone: _____________________________ Fax: _________________________Cell: ______________________


Referer: (Newspaper, Search Engine, Word of Mouth etc.)______________________________________________________

Account name:______________________________________________________Vat No: ______________________

Account number: |__|__|__|__|__|__|__|__|__|__|__|__| Branch name: __________________________


Branch code: |__|__|__|__|__|__| Account type: Current / Transmission / Savings / Other:_________

Bank: FNB: |__| Standard:|__| ABSA: |__| Nedbank:|__| Other: ___________


Primary Business: e.g. Civil, Building, Electrical_______________________________________For Admin Purpose Only.

My agreement to subscribe to Cedrus Internet Solutions Pty LTD:

1. Monthly Daily Tenders South Africa: ZAR 680.00 |__|VAT Included.
2. Monthly Daily Tenders Africa: ZAR 790.00 |__|VAT Included.
3. Monthly Daily Tenders South Africa and Africa: ZAR1200.00 |__|VAT Included.

Please debit my/our account on the: 15th of the month c OR the last working day of the month c

The First debit will include an adjustment for the balance of the first month. First debit date within 14 days of fax date, and thereafter on the day of the month as indicated above. I/We hereby request, "instruct" and authorise you to draw against my/our account with the above mentioned bank (or any other bank or branch to which I/we may transfer my/our account) the amount necessary for payment of the chosen subscriptions, any services used and any increases applied in respect of the above mentioned. All such withdrawals from my/our bank account by you shall be treated as though they had been signed by me/us personally. I/We agree to pay any bank charges relating to this debit order instruction. This authority may be cancelled by me/us by giving you thirty days notice in writing, but I/we understand that I/we shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force if such amounts were legally owing to you.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.

Signed at .............................................. on this ......... day of .........................../20.....


Authorised Signatory Name

___________________________________


Assisted by: (Where legally necessary)

___________________________________

__________________
Signature

_________________
Capacity

_________________
Signature

__________________
Capacity
Please fax this form and a used cheque (for identification purposes) to 033-3435882. Your subscription will be processed immediately on receipt of fax.
Please note that rates are subject to an annual increase.