Transcription of SINGAPORE POOLS (PRIVATE) LIMITED
1 APPLICATION FOR direct debit PAYMENT AUTHORISATIONSINGAPORE POOLS ( private ) LIMITEDPART 1: FOR APPLICANT S COMPLETION (Fill the spaces indicated with ) Date:DDMMYYYYName of Billing Organisation ( BO ): SINGAPORE POOLS ( private ) LIMITED To:q DBS Bank Ltd (Company Registration No. 196800306E)q Overseas-Chinese Banking Corporation LIMITED (Company Registration No. 193200032W)q United Overseas Bank LIMITED / Far Eastern Bank LIMITED (Company Registration No. UOB 193500026Z / FEB 195800116D)My Instruction(s) To Above-Mentioned Bank:(a) By signing below, i hereby instruct you to process the BO s instructions to debit my account specified below.(b) I agree to be bound by the direct debit payment conditions set out in the Account Opening and Operating Terms and Conditions.(c) I acknowledge and agree that this authorisation shall not take effect until I receive your written notification that my application for direct debit Payment authorisation has been approved.
2 (d) I agree that you have the absolute discretion to amend the per transaction limit (where applicable) or maximum daily total limit ( limits ) that I have applied for herein, or to decline my application without giving any reason and also to retain any document I have submitted pursuant to this application as your property. Any changes proposed to be made by me to any of the limits may only be effected with your approval. For the avoidance of doubt, any changes or modifications to the limits shall only take effect from the date of your letter to me.(e) I agree to the prevailing prescribed rate of S$ for each debit request, and I also agree the Bank shall have the right to make such changes or adjustments to this prescribed rate as the Bank in its sole discretion deems fit. My Name: (As in Bank s Records) My Account Type: q Savings Account q Current Account (Personal Account in Single Name ONLY - No Joint Account) My Account Number to be Debited: My Per Transaction Limit^ is: (Applicable to DBS & OCBC Accounts Only) My Contact Number(s): Home Tel:Office Tel:Mobile Tel: My Maximum Daily Total Limit is: q $5,000 q $25,000 q $50,000 My Instruction to SINGAPORE POOLS :Please Transfer the Funds from My Betting Account to My Bank Account.
3 Q Daily q Weekly q Monthly My Signature / Thumbprint*: (As in Bank s Records)* For thumbprint, please proceed to branch of bank with your identification card / passport. ^ For DBS accounts only: If left blank, $5,000 will be 2: FOR SINGAPORE POOLS ( private ) LIMITED S COMPLETIONSWIFTBICS ingapore POOLS ( private ) LIMITED s Account POOLS ( private ) LIMITED s Customer s DDA Reference of Approving OfficerAuthorised Signature (Approving Officer)DatePART 3: FOR BANK S COMPLETIONTo: SINGAPORE POOLS ( private ) LimitedThis application is REJECTED for the following reason(s): Please tick ( ) and please delete where inapplicable # q Signature / Thumbprint# Differs from Bank s records q Wrong Account number q Signature / Thumbprint# Incomplete / Unclear# q Amendments not countersigned by Customer q Account not operated by Signature / Thumbprint# q Others:_____ Name of Approving OfficerAuthorised Signature (Approving Officer)DateSep16 private & Confidential(Company Registration No.)
4 196800202G)fold herefold herePostage will be paid by addressee. For posting inSingapore to use the Business Reply Envelope (BRE)Fold along dotted documents into businessreply folder, folding along edges of folder with clear tape (do not staple).Drop sealed folder into post here with clear tapeSeal here with clear tapeSeal here with clear tapeSeal here with clear tapeHave and signed the form?BUSINESS REPLY SERVICEPERMIT NO. 07761 Bras Basah Post Box 299 SINGAPORE 911810 Attention: Customer Support
