E-Mandate

Electronic debit order mandates for your business.

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(DD) #00 DDL002 – Direct Debit (E-Mandate Signup)

Order reference*
For office use only.
Black Friday Special: 30% Off Application Fee Applied.
E-Mandate package*
Discounted pricing only offered to Direct Debit customers
- Direct Debit customer
- I am using another debit order provider
Direct Debit customer code*
If you do not know your user code, please request this from Direct Debit.
Emandate type*
Setup fee (Standard w/ Direct Debit - 25% Off Black Friday)
Price: R2,208.00
Incl. VAT
Setup fee (Standard w/ Direct Debit)
Price: R2,060.80
Incl. VAT
Monthly fee (Standard w/ Direct Debit)
Incl. VAT
Setup fee (Integrated w/ Direct Debit)
Price: R5,462.50
Incl. VAT
Monthly fee (Integrated w/ Direct Debit)
Incl. VAT
Setup fee (Standalone)
Price: R6,325.00
Incl. VAT
Setup fee (Standalone)
Price: R4,427.50
Incl. VAT
Monthly fee (Standalone)
Incl. VAT
Fee per mandate per month (Standalone)
Incl. VAT
Business information
Company name*
VAT number
Trading address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact information
Name*
First Last
Cellphone number*
Email address*
Setup information
Business logo
Minimum width 320px
Customisation options
- No customisation required.
- I require custom form fields.
- I require custom form fields and agreement text.
- I require custom form fields, agreement text and email wording sent to customer.
Custom form fields*
Please specify the fields required.
Field name Field type
Shortname registered with debit provider*
Can only be 10 characters long and should be the legal entity or trading as name.
Client reference preference*
- Specific reference that increments
- Generate random references
Specific reference starting with*
References can only be 14 characters in total.
Website
Which website should the mandate redirect to, after the client has signed?
Admin notification emails*
Indicate where the admin notification emails should go.
Agreement text*
Do you require any custom agreement text?
Example text: Abbreviated short name as registered with the acquiring bank: <SHORTNAME> Refer to our contract reference number (“the Contract Reference Number”). I/We hereby authorise Direct Debit to issue and deliver payment instructions to your banker for collection against my/our abovementioned account at my/our abovementioned bank on condition that the sum of such payment instructions will not differ from my/our obligations as agreed to in the Contract Reference Number. The individual payment instructions so authorised must be issued and delivered on the date when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not differ as agreed to in terms of the Agreement. I/we agree that the first payment instruction will be issued and delivered on the "Start Date" and thereafter regularly on the "Action Day" of each month. If however, the date of the payment instruction falls on a non-processing day (weekend or public holiday) I agree that the payment instruction may be debited against my account on the following business day; or subsequent payment instructions will continue to be delivered in terms of this authority until the obligations in terms of the Agreement have been paid or until this authority is canceled by me/us by giving you notice in writing of not less than the interval (as indicated in the previous clause) and sent by prepaid registered post or delivered to your address indicated above. Mandate I/we acknowledge that all payment instructions issued by you shall be treated by my/our abovementioned bank as if the instructions had been issued by me/us personally. Cancellation I/we agree that although this authority and mandate may be cancelled by me/us, such cancellation will not cancel the Agreement. I/we also understand that I/we cannot reclaim amounts, which have been withdrawn from my/our account (paid) in terms of this authority and mandate 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.
Pre-populate mandate*
Do you want to post to the mandate via query-string (e.g. ?firstname=John&surname=Doe) using your own signup process?
- Yes
- No
Raw export email*
Do you want to receive an export of the raw data signed? If so, please provide email address where email should be sent.
Webhook*
Do you require a webhook of the raw data signed? If so, please provide the URL where the webhook should post to.
Custom email wording*
The notification email to a client includes the signed PDF mandate and can be customised.
Payment information
Coupon Code

Do you have a discount coupon?
Once-off setup fee:
How would you like to pay?
Please make payment to:
Direct Debit (Pty) Ltd
First National Bank
Account number: 62361026943
Branch code: 250655
Account type: Current
Use your unique "Order reference" at the top of this form "EM1231DD" as payment reference and continue submitting your order.
Payment information*

American Express
Discover
MasterCard
Visa
JCB
Maestro
Card Number Expiration Date Security Code Cardholder Name
Monthly fee (via debit order):
Account holder*
Bank*
Branch code*
Account number*
Account type*
Terms of agreement*
Abbreviated short name as registered with the acquiring bank (setup fees): "DIRECT DEBIT"
Abbreviated short name as registered with the acquiring bank (monthly fees): "DDEBIT"
I/We hereby authorise Direct Debit (Pty) Ltd to issue and deliver payment instructions to your banker for collection against my/our abovementioned account at my/our abovementioned bank on condition that the sum of such payment instructions will not differ from my/our obligations as agreed to in the Client Reference Number.
The individual payment instructions so authorised must be issued and delivered on the date when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not differ as agreed to in terms of the Agreement.
I/we agree that the payment instruction will be issued and delivered on the 1st of every month.
If however, the date of the payment instruction falls on a non-processing day (weekend or public holiday) I agree that the payment instruction may be debited against my account on the following business day; or subsequent payment instructions will continue to be delivered in terms of this authority until the obligations in terms of the Agreement have been paid or until this authority is cancelled by me/us by giving you notice in writing of not less than 30 days.
Direct Debit (Pty) Ltd may vary the fees payable under these terms and conditions by giving 1 (one) month written notice to the User.
Mandate
I/we acknowledge that all payment instructions issued by you shall be treated by my/our abovementioned bank as if the instructions had been issued by me/us personally.
Cancellation
I/we agree that although this authority and mandate may be cancelled by me/us, such cancellation will not cancel the Agreement. I/we also understand that I/we cannot reclaim amounts, which have been withdrawn from my/our account (paid) in terms of this authority and mandate 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.
- I agree to the terms of agreement
Total due immediately
R0.00
Signature*
Signature verified by Bank
Comments
This field is for validation purposes and should be left unchanged.

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