Welcome To Customs Credit Co-operative Society

35 Selegie Road #04-01, Parklane Shopping Mall, Singapore 188307 | TEL : +65 6338 4890 | FAX : +65 6338 4870 | EMAIL : cccsl@singnet.com.sg

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Apply For Direct Debit Authorisation
Privileges>>Apply For Direct Debit Authorisation

* Compulsary fields
A. APPLICANT'S PARTICULARS
Name(s) as in Bank Account	:	*
NRIC	:	- *
Correspondence Address	:
Contact Telephones:
Office	:	*
Home	:	*
Mobile	:	*
Pager	:
B. APPLICANT'S BANK DETAILS
Bank Name	:
Bank Branch	:
Bank a/c No.	:	*
C. DIRECT DEBIT INSTRUCTION
Name of Billing Organisation (BO)	:	*
Amount		$30 $50 $100 $150 $200 Others, please specify:
D. OTHER INSTRUCTIONS
I / We hereby instruct you to process the BO's instruction to debit my / our account monthly.
You are entitled to reject the BO's debit instruction if my / our account does not have sufficient funds and charge me / us a free of this. You may also at your discretion allow the debit event if this results in an overdraft on the account and impose charges accordingly.
This authorization will remain in force until terminated by your written notice sent to my / our address last known to you or open receipt of my / our written revocation through the BO's
Date	: *

Please click here for Download Direct Debit Authorization Form and mail it to us.