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(Kindly complete this form in black)

BANK DETAILS

I, Zwelakhe Msuthu , (Employee No )


enclose my Bank Account details.

BANK: FNB STANDARD NEDBANK ABSA MERCANTILE CAPITEC

AFRICA TYME BIDVEST OTHER:


DISCOVERY INVESTEC
BANK BANK BANK

BRANCH:

ACCOUNT NUMBER: 1 4 7 9 2 1 1 4 8 0 7

BRANCH CODE: 6 7 9 0 0 0

CHEQUE SAVINGS TRANSMISSION


TYPE OF ACCOUNT:

EMPLOYEE SIGNATURE:

DATE: d1 d
2 / m
0 m
7 / 2 0 2y 3y

PLEASE RETURN THIS COMPLETED FORM TO YOUR HUMAN RESOURCES DEPARTMENT WITH A BANK
LETTER/STATEMENT AND CERTIFIED ID DOCUMENT ATTACHED. BANK LETTER/STATEMENT MUST NOT
BE OLDER THAN 3 MONTHS.

FOR AVI USE ONLY


COMPULSORY PHYSICAL VERIFICATION OF BANK DETAILS

HUMAN RESOURCES LINE MANAGER

CHECKED BY: CHECKED BY:

SIGNATURE: SIGNATURE:

DATE: DATE:

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