Monthly Debit Donation to Daarul Qur’aan Institute

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Please note that this is for Lillah only. Should you wish to make a Zakaah payment or if you require a S18A receipt, kindly contact chairman@quranunion.co.za. Debits may go off a day or two after the selected date if it falls on a Sunday or public holiday.

Account Holders name *

Address (account holder) *

Contact number *

Write amount (in Rand) *

Write amount (in words) *

Bank’s name *

Account no *

Branch no *

Account type *

Cheque

Savings

Transmission

Other:

Select debit day (of every month) *

1st

5th

15th

25th

Date on which debit start *

YYYY

I/We hereby authorize Daarul Qur’aan Institute to issue and deliver payment instructions to its banker for collection against my/our abovementioned bank the above sum on or after the stipulated debit date of each and every month for the said period. The amount of each individual payment instruction may not be more or less than the obligation due. I/we acknowledge that all payment instructions issued by Daarul Qur’aan (in accordance to the agree-ment) shall be treated by my/our abovementioned bank as if the instructions had been issued by me/us personally and I/we agree to pay any bank charges relating to this debit order instruction. This Debit order authority may be cancelled by me/us by giving Daarul Qur’aan Institute notice in writing of not less than an interval of thirty days that will be sent by prepaid registered post or delivered by email.I/We acknowledge that this authority may not be ceded or assigned to a third party unless it is within our agreement.

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