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    Banking Details Update Form - 0

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    ConwellLess
    This document is an electronic funds transfer form for SAMRO to pay distribution royalties via EFT. It requests the composer/author's personal details, identity number, contact information, publisher details if applicable, banking details and signature. The form must be completed, signed and submitted with supporting identity and banking documents to SAMRO to set up EFT payments of royalties.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Banking Details Update Form - 0

    Uploaded by

    ConwellLess
    111 views2 pages
    This document is an electronic funds transfer form for SAMRO to pay distribution royalties via EFT. It requests the composer/author's personal details, identity number, contact information, publisher details if applicable, banking details and signature. The form must be completed, signed and submitted with supporting identity and banking documents to SAMRO to set up EFT payments of royalties.

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    Banking Details Update Form_0

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    This document is an electronic funds transfer form for SAMRO to pay distribution royalties via EFT. It requests the composer/author's personal details, identity number, contact information, publisher details if applicable, banking details and signature. The form must be completed, signed and submitted with supporting identity and banking documents to SAMRO to set up EFT payments of royalties.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    111 views2 pages

    Banking Details Update Form - 0

    Uploaded by

    ConwellLess
    This document is an electronic funds transfer form for SAMRO to pay distribution royalties via EFT. It requests the composer/author's personal details, identity number, contact information, publisher details if applicable, banking details and signature. The form must be completed, signed and submitted with supporting identity and banking documents to SAMRO to set up EFT payments of royalties.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    ELECTRONIC FUNDS TRANSFER FORM

    “Entirely Without Prejudice or Admission of Liability”

    In order for us to pay your Distribution Royalties via “Electronic Funds Transfer” (EFT), kindly complete this
    form and deliver the form to SAMRO (SAMRO Place, 20 De Korte Street, Braamfontein, Johannesburg,
    Gauteng Province), or fax to 086 674 4391, or e-mail to [email protected]

    Composer / Author

    Surname Full Name(s)

    Identity / Passport Number

    Telephone / Mobile Number E-mail Address

    Publisher

    Company Name Company Registration Number

    Telephone / Mobile Number E-mail Address


    PLEASE ATTACH A COPY OF YOUR ID / PASSPORT, PROOF OF BANKING DETAILS (FIRST PAGE OF YOUR
    BANK STATEMENT OR LETTER FROM THE BANK), AND PROOF OF RESIDENCE.

    Banking Details

    Account Holder’s Full Name(s) & Surname

    Bank Account Number Branch Name / Code

    Type of Account Cheque/ Transmission Savings/Mzansi


    Current

    I declare that the information given above is true and correct, and that I am authorised to sign in my personal
    capacity or on behalf of the Company. Should any of the above information change at any time, SAMRO will be
    notified immediately to avoid any delay in payments, or payment into an incorrect bank account. In addition, I
    agree and accept that, in the event of the above information being incorrect, SAMRO will not be held responsible
    for any delay and/or loss.

    Account Holder’s Signature Date

    PLEASE NOTE: WE ARE UNABLE TO ACCEPT PERSONAL ACCOUNT DETAILS FOR PUBLISHING COMPANIES

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