Signature Schedule To Supplier Payment Service Agreement - Short Form v2

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Signature Schedule to Supplier Payment Service Agreement

*All capitalised words, definitions and phrases shall, unless the context indicates otherwise, have the same meaning as defined in the ‘Supplier Payment
Service Agreement’ entered into:

between

Kazang, a division of Main Street 1723 (Pty) Ltd (with registration number 2019/300711/07 and registered address at 5 on Century City Drive, 5 Century
Boulevard, Century City, Cape Town, 7441)
(which is referred to as "Kazang" in the Supplier Payment Service Agreement attached hereto).

and

Supplier’s Registered
Entity Name Trading as:
(“Supplier”):
Registration
No:

Physical Address: VAT No:

Tel. No:

Postal Address: Cell No:

E-mail:

Superwallet
Ref No:

Supplier’s Bank Account

Account Supplier Signature


Bank Name
Holder
Branch &
Account Number
Branch Code
* Please attach Bank Account confirmation letter not older than 3 months

Transaction Fees

Transaction Fee (excl. Gross settlement Net settlement Supplier Signature


%
VAT) method method
Supplier confirms the Transaction Fee was completed at the time of signature.

Supplier’s Finance Contact Supplier’s Operations/Business Contact

Name of Contact:

Work number:

Cell number:

E-mail address:

Signature Schedule
By its signature hereunder, the Supplier hereby confirms it has read, accepts and agrees to the terms and conditions of the Supplier Payment Service
Agreement as contained on the Kazang website (https://www.kazang.com/supplier-payment-service-agreement/) and available in hard copy upon request
read together with Kazang's general terms and conditions (www.kazang.com).

This Schedule is executed at by (Insert Full Name) in his / her capacity as

on this day of 20 .

Supplier Signature
(duly authorised)
FOR OFFICE USE ONLY

Signed at on this day of Kazang


20 _ . (duly authorised)

Supplier Code/ Kazang Permanent/ Temporary


Account Number Supplier

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