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_Important Please read “Notes on application for Interbank GIRO”_

VIEWS: 5 PAGES: 1

									                                         NATIONAL SERVICE RESORT & COUNTRY CLUB (NSRCC)
                                                              10 Changi Coast Walk
                                                                Singapore 499739
                                                    Telephone: 6542 8288 Facsimile: 6545 6508

                                                                                          Amendments to previous instruction
               New Application                                                            Effective Date: _________________
       APPLICATION FOR MONTHLY PAYMENT BY CREDIT CARD
       For Applicant’s Completion

       Name of Member & NRIC / Passport Number                                     Charge to My Credit Card

                                                                                          VISA                              MASTERCARD
                                                                                   Issuing bank:

       NSRCC Membership Number                                                     Credit Card Number
                                                                                                   -                  -                  -


       My Mailing Address                                                          Credit Card Expiry Date



       Singapore

       My Contact Number (s)                                                       Name And Signature As Per Credit Card
                                                                                   Name :
       Home :

       Office :                                                                    Signature :

       Mobile / Pager :

       E-mail:

       (a) I / We hereby authorize NSRCC to charge my due outstanding owing as per my monthly member’s statement of account*
           to my credit card.

       (b) This authorisation will remain in force until terminated by your written notice sent to my / our last address last known
           to NSRCC or upon receipt of my / our written revocation through NSRCC.




       ------------------------------------------------------                     --------------------------------------------------------------------
       Date                                                                       My / Our Company Stamp / Signature (s)

       IMPORTANT NOTES ON MONTHLY PAYMENT BY CREDIT CARD

        1. Application must be accompanied by the latest copy of credit card statement, or photocopy of credit card (front & back)**
        2. Applicant to make bill payment on behalf of another party must be in person.
        3. Please continue to pay by cash, cheque, nets or auto phone/internet banking (OCBC/DBS) for all your bills until your application
           is approved.
        4. The bill amount will be charged to your credit card on the 15th of each month (if 15th fall on Saturday/ Sunday/Public Holiday,
           the deduction will be on the following working day) and your credit card statement will also show the amount charged.
        5. To terminate this instruction permanently, please write to National Service Resort & Country Club, 10 Changi Coast Walk,
           Singapore 499739, Attention to: Finance Dept. Please check your next bill details if the Credit Card payment arrangement is still
           effective.
        6. To update your change in credit card, please submit this form again.
        7. Please call us at 6540 8589 / 8588 or email to us at finance@nsrcc.com.sg if you have any enquires.

            *Subscription fees / Club bills / Installment entrance fees if applicable
            ** Application will not be accepted without the copy of the credit card.
AUTH FORM – Recurring CC

								
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