Scribd
Upload
48 views1 page

Direct Debit Authorization Form

The document is an authorization form allowing the Tung Wah Group of Hospitals to debit specified amounts from the signer's bank and credit card accounts. It outlines the responsibilities of the signer regarding overdrafts, insufficient funds, and the process for cancellation or modification of the authorization. Additionally, it states that annual donation receipts will be issued by May 31 each year.

Uploaded by

浩堂林
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
48 views1 page

Direct Debit Authorization Form

The document is an authorization form allowing the Tung Wah Group of Hospitals to debit specified amounts from the signer's bank and credit card accounts. It outlines the responsibilities of the signer regarding overdrafts, insufficient funds, and the process for cancellation or modification of the authorization. Additionally, it states that annual donation receipts will be issued by May 31 each year.

Uploaded by

浩堂林
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

1.

本人/吾等現授權本人/吾等之上述銀行（根據受益人不時給予本人/吾等銀行之指示），自本人/吾等之賬戶內轉賬予上述受益人。 I/We hereby authorize my/our above named Bank to effect transfer from my/our account to that of the above named beneficiary in
accordance with such instructions as my/our Bank may receive from the beneficiary from time to time.
2. 本人/吾等同意本人/吾之銀行無須證實該等轉賬通知是否已交予本人/吾等。I/We agree that my/our Bank shall not be obliged to ascertain whether or not notice of any such transfer has been given to me/us.
3. 如因該轉賬而令本人/吾等之賬戶出現透支（或令現時之透支增加），本人/吾等願共同及個別承擔全部責任。I/We jointly and severally accept full responsibility for any overdraft (or increase in existing overdraft) on my/our account which may arise as a result of
any such transfer(s).
4. 本人/吾等同意本人/吾之賬戶並無足夠款項支付該等授權轉賬，本人/吾等之銀行有權不予轉賬，且銀行可收取慣常之費用。I/We agree that should there be insufficient funds in my/our account to meet any transfer hereby authorized, my/our Bank shall be entitled,
in its discretion, not to affect such transfer in which event the Bank may make the usual charge.
5. 本人/吾等同意，本人/吾等取消或更改本授權書之任何通知，須於每月20日前交予本人/吾等之銀行，並同時通知上述受益人。I/We agree that any notice of cancellation or variation of this authorization which I/We may give to my/our Bank shall be given on 20th of
each month and at the same time such notice shall be given to the beneficiary.
6. 本人（等）確認本人（等）在此表格上的簽署與本人（等）用以轉賬的戶口的簽署相同。本直接付款授權書將繼續生效直至通知為止或會通知東華三院任何銀行戶口的變更或取消交費方式。We confirm my/our signature(s) on this form is/are the same as the
signature(s) of my/our Bank account given above. Until further notice, I/We hereby authorize Tung Wah Group of Hospitals to initiate and the Bank named above to process debits to my/our account from time to time.

1. 簽名必須與 閣下（等）之戶口簽名完全相同，表格上如有任何塗改，請在旁簽署。Please ensure that the signature used is the same as that on your credit card , and sign all amendments in the same way.
2. 本人現授權東華三院由本人之信用卡賬戶內定期扣除上述之款項，直至另行通知為止。本人同意此授權書於本人之信用卡有效期後及獲續發新卡時繼續生效，並無須另行填寫通知書。如須要取消或更改本授權書，須於每月20日前以書面通知東華三院。I/We hereby
authorize Tung Wah Group of Hospitals to change my/our card account for the relevant amounts specified above. This authorization shall have effect until further notice. I/We agree that this authorization shall have effect after the valid date of the credit card
or replacement of the credit card, and no authorization form will be submitted again. I/We agree that any notice of cancellation or variation of this authorization shall be given on 20th of each month such cancellation/variation is to take effect.
3. 信用卡捐款可傳真至2559 6835, 傳真後無須再寄交表格，以免重複扣除捐款。 If you submit this authorization form by fax, you are not required to mail this form to Tung Wah again.

全年捐款收據將於每年5月31日前寄奉，以作紀錄。The annual donation receipt will be issued by 31 May every year for your record.

You might also like