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FAX-TO-MAIL APPLICATION
I, (the applicant) hereby applies for the following services (the services) provided by Interexcel at the prescribed fee;

Service Description
Charge (VAT Incl)
E-Mail addresses to be linked
Other charges

Local ( Cape Town, Johannesburg, Durban, Pretoria ) - R0.80 per minute, then R0.40 per 30 seconds.

National (Outside the 50Km radius) - R1.50 per minute, then R0.40 per 30 seconds.

 

Subject to the following terms and conditions.

  1. This application will serve as the valid and binding contract between the Applicant and Interexcel after due completion and signature thereof by Applicant and receipt hereof by Interexcel, for the provision of the services.
  2. Notwithstanding anything to the contrary, all services provided herein shall be subject to Interexcel's Internet Services Agreement, Copies of which are available on the internet at http://www.interexcel.co.za/terms.html or at Interexcel's offices at: 101 The Club, 23 Dely Rd, Hazelwood, PRETORIA, and the contents of which the Applicant by signature hereto, certifies having read, understood and agreed to.
  3. The services will be provided by Interexcel with effect from the first day of the calendar month during which the first payment by debit order in terms hereof is effected.
  4. Payment for services will be made monthly in advance on the 1st day of the month, by debit order, for purposes of which the authorisation for payment by debit order hereunder is completed and submitted to Interexcel as part of this application.
  5. Interexcel reserves the right to, without notice, suspend all services if payment in terms of paragraph 4 hereof is not duly effected on due date thereof, and to terminate this agreement forthwith and without notice if such payment is not effected on/before the next payment in terms of this application become due and payable, and/or if such payment is not also duly made on due date thereof.
  6. Subject to the provisions hereof and Interexcel's Internet Service Agreement referred to in paragraph 2 hereof, the services will be provided for a 12 (twelve) month period, whereafter this application will automatically be renewed unless terminated by either party in writing at any time thereafter by giving 1 (one) calendar months notice.
  7. Interexcel hereby excludes liability for any reason whatsoever arising from the services in terms of this application or otherwise or any warranties or representations hereto other than specified in Interexcel's Internet Service Agreement.
1.   DETAILS
 
Title:
ID:
Initials:
Surname:
Physical Address:
PO Box
Tel(w):
Tel(h):
Cell:
Fax:
       
2.   AUTHORISATIONS FOR DEBIT ORDER PAYMENT

 
Bank:
Branch:
Branch Code:
Account Number:
Account Type:
Cheque
Savings
Transmission
Other 
 Please Specify
Name Of Account Holder:

I, hereby give authorisation to Interexcel to withdraw from my/our account, detailed above, their Fax-to-Mail Services subscription in the amount of R on the first of every calendar month. The first of these payment to be deducted from the / for a period of 12 (twelve) months and thereafter monthly until I supply one calendar month in advance written notice of termination of this payment agreement to INTEREXCEL.