Application for Payments to Third Persons Information
Choose bank ABN Amro Bank NV Johannesburg Branch Absa Bank Limited African Bank Limited Bidvest Bank Limited Capitec Bank Limited Citibank N.A. South Africa Branch Calyon Corporate and Investment Bank FirstRand Bank Limited Grindrod Bank Limited Habib Overseas Bank Limited HBZ Bank Limited - South Africa Investec Bank Limited Sponsored non-bank by ABSA Mercantile Bank Limited Nedbank Limited Post Bank Limited Societe Generale Johannesburg Branch South African Reserve Bank The South African Bank of Athens Limited Standard Chartered Bank Johannesburg Branch State Bank of India Teba Bank Limited The Standard Bank of SA Limited hereby inform PASA, in terms of the Directive for Payments to Third persons, Directive No. 1 of 2007, that we sponsor the following institution and confirm that they are corporate clients of our bank.
We hereby wish to inform PASA of our client's details for purposes of authorisation as a Third Party Payments provider:
Fields marked with an * are mandatory
Full Name of Institution		*
Contact Person		*
Physical Address		*
		*
		*
Physical Code		*
Postal Address		*
Postal Code		*
Office Number		*
Fax Number
Cell Phone Number
E-mail address		*
The applicant provides/will provide services in respect of the following:	ATM AEDO NAEDO Cheque Credit Card Mastercard Visa None Debit Card EFT Credits EFT Debits RTC Bureaux Services (i.e. Swift) Please Specify: Other Please Specify:
REQUESTED BY
Full Name		*
Contact Number		*
E-mail address		*
Designation	PASA Authorised Contact of Sponsoring Bank Other Designation