AGREEMENT FOR PAYMENT INSTALMENT OF SAIAT MEMBERSHIP FEES

AGREEMENT FOR PAYMENT INSTALMENT OF SAIAT MEMBERSHIP FEES - 2023
1. PERSONAL INFORMATION

PLEASE TYPE IN CAPITAL LETTERS
1.1 Surname:*
1.2 Full names:*
1.3 SAIAT Membership Number:*
1.4 Invoice Number:*
2. CONTACT DETAILS
2.1 Residential Address:*

Street Address

Street Address Line 2

CityProvince

Postal Code
2.2 Postal Address:*

Postal Address

Postal Address Line 2

CityProvince

Postal Code
2.3 Email Address:*
2.4 Mobile Telephone Number:*

Area CodePhone Number
3. INSTALMENT DETAILS
3.1 Number of instalments*

3 without PI3 with PI6 without PI6 with PI10 without PI10 with PI
3.2 Instalment amounts:

3 × without PI = 2 × R820.00 & R810.00

3 × with PI = R2 × R1 240.00 & R1 220.00

6 × without PI = 5 × R410.00 & R400.00

6 × with PI = 5 × R620.00 & R600.00

10 × without PI = 10 × R245.00

10 × with PI = 10 × R370.00

Please select the appropriate option at 3.1 before you supply the instalment dates.
1st Instalment*

MonthDayYear
Date
2nd Instalment*

MonthDayYear
Date
3rd Instalment*

MonthDayYear
Date
4th Instalment*

MonthDayYear
Date
5th Instalment*

MonthDayYear
Date
6th Instalment*

MonthDayYear
Date
7th Instalment*

MonthDayYear
Date
8th Instalment*

MonthDayYear
Date
9th Instalment*

MonthDayYear
Date
10th Instalment*

MonthDayYear
Date
Supply payment dates*
4. INSTALMENT AGREEMENT
4.1 SAIAT does not have a debit order system. It is the responsibility of the member to arrange with their financial institution to make such arrangements if required.

4.2 Any missed instalment will render this agreement void and the full balance will become payable immediately.
Date*

DayMonthYear
Signature*
Should be Empty:

AGREEMENT FOR PAYMENT INSTALMENT OF SAIAT MEMBERSHIP FEES - 2023

1. PERSONAL INFORMATION

2. CONTACT DETAILS

3. INSTALMENT DETAILS

4. INSTALMENT AGREEMENT