DIRECT DEBIT AUTHORISATION 直接付款授权书.doc

DIRECT DEBIT AUTHORISATION 直接付款授權書 Name of Party to be Credited (The Beneficiary) 收款的一方 (收款人 ) Bank No. 銀行號碼 Branch No. 分行號碼 Account No. 戶口號碼 Brio Electronic Commerce Limited T/A ecTDEC 004 404 446650-838 My / Our Bank Name and Branch 本人 (等) 的銀行及分行的名稱 Bank No. 銀行號碼 Branch No. 分行號碼 My / Our Account No. 本人 (等) 的戶口號 My / Our Name (s) as recorded on Statement / Passbook (in Block Letters) 本人(等 ) 在結單/ 存摺上所紀錄的名稱 (請以英文正楷填寫 ) HK Identity Card / Business Registration Number of Account-Holder (s) 賬戶持有人之身份証 / 商業登記號碼 Tel No. 電話號碼 Maximum Limit 最高付款限額 Note : If Blank, the debtor’s bank will set as “unlimited” 注意: 如無填寫, 付款銀行會將轉賬限額設定為「不設上限」 Expiry Date (day/month/year) 到期日 (日/月/年) Note: If blank, this authorization shall have effect until further notice and Expiry Date should be greater than 3 months.注意: 如無填寫, 此直接付款授權書無限期有效直至另行通知及到期日必須大於三個月 / / My / Our Address as recorded on Statement / Passbook 本人 (等) 在結單 / 存摺上所紀錄的地址 Debtor Name (in Block Letters) 付款人名稱 (請以英文正楷填寫) Note: Please specify if other than Account Holder注意: 如非戶口持有人, 請填寫 Debtor Reference (Compulsory Field) 付款人編號 (必須填寫) (Reference between yourself and the party to be credited 貴賬戶與收款一方的編號) Declaration 聲明 I / We hereby authorise my/our above named Bank to effect transfers 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 and/or its banker and/or its banker’s correspondent from time to time provided always that the amount of any one such transfer shall not exceed the limit indicated above. 本人 (等) 現授權本人 (等) 的上述銀行, (根據收款人或其往來銀行及 / 或代理行不時給予本人 (等) 銀行的指示) 自本人 (等) 的戶口內轉賬予上述收款人, 惟每次轉賬金額不得超過以上指定的限額。 I / We agree that my/our Bank shall not be obliged to ascertain whether or not notice of any such transfer or reversal notice has been given to me/us. 本人 (等) 同意本人 (等) 的銀行毋須證實該等轉賬通知或沖銷通知是否已交予本人 (等)。 I / We jointly and severally accept full responsibility for any overdraft (or increase in existing over