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RECURRING PAYMENT VIA CREDIT CARD INSTRUCTIONS by htt39969

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									              SERVICE AND CONSERVANCY CHARGES (S&CC)
           RECURRING PAYMENT VIA CREDIT CARD INSTRUCTIONS

IMPORTANT NOTICE

*All information on this form must be fully completed, otherwise the payment cannot be processed.



To:         Tampines Town Council

            Block 136 Tampines Street 11

            Singapore 521136



Fax:        67847296

Attn:       Finance Department




I hereby authorise Tampines Town Council to charge my credit card (details below) for the payment of S&CC due.




Name of Resident                  : (Mr/Mrs/Mdm/Miss)



Contact Number                    : (H)                           (O)                          (H/P)



Town Council Ref Number           :                      -                        -        -



Amount to be debited Monthly      : S$                        -



Credit Card Details



Type of Card                      :       Mastercard              Visa     Name of Bank:



Cardholder's Name                 :



Card No.                          :                      -                        -                     -



Card Expiry Date (MM/YYYY)        :            -




Cardholder's Signature            :




Date                              :

								
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