Vodacom Business Contract

Vodacom Commercial Park, 082 Vodacom Boulevard, Vodavalley, Midrand, 1685 South Africa
P.O. Box 3306, Cramerview 2060 | Tel: 082 1940 | www.vodacom.co.za
Vodacom Service Provider Company (PTY) Ltd (Hereinafter referred to as "VSP"
Reg No. 1991/001471/07 Vat Reg no. 4190152084

Customer Details

Do you have an existing account? Yes No

Type of Company:

Public Company Public Company (PTY) LTD Close Corporation (CC) Sole Proprietor Government Trust Professional Partnership Other

Account No:

Company Registered Name:

Trading As:

Registration No:

VAT Registration No:

Period in Existence (Years):

Nature of Business / Sector:

Physical Address – Street No:

Street Name:

Town / City:

Postal Code:

Tel No:

Cellphone Administrator

Name:

Email Address:

Tel No:

Details of Directors / Proprietors / Partners

Principal 1 – Name & Surname:

ID No:

Designation:

Physical Address:

Principal 2 – Name & Surname:

ID No:

Designation:

Physical Address:

Payment Details – Debit Order Authorisation

Account Holder Name:

Bank Name:

Branch Name:

Branch Code:

Account No:

Bank Account Type:

Cheque Savings Transmission

Debit Order Date:

1st 7th 15th 20th 25th 27th Last Working Day

Please deduct payment as per the payment method selected above in favour of Vodacom Service Provider Company (PTY) Ltd with the total amount owing per month under this agreement

Authorised Signatory Name:

Signature:

Date:

Important Information

- Activations Refer to the Activations Authorisation Form

- Tariff Information Refers to the Vodacom Tariffs Brochure

- Rica Registration: You are required to register your details with the Vodacom RICA Agent in order for your SIM card to be connected on the Vodacom Network

- Customer Selection Confirmation Form

- Vodacom Service Provider Company (PTY) Ltd full Terms and Conditions are available on: https://www.vodacom.co.za/vodacom/terms/terms-and-conditions?icmp=Home/Footer/TermsAndConditions

Declaration

I have read, understood and agree to be bound by the terms and conditions that accompany this application form and declare that the information given above is true and correct and that I hereby consent to Vodacom Service Provider Company (PTY) Ltd credit vetting this information

Authorised Signatory Name:

Signature:

Date: