Form Ui-2.8 - Authorisation To Pay Benefits Into Banking Account - Department Of Labour, Republic Of South Africa

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UI-2.8
labour
Department:
Labour
REPUBLIC OF SOUTH AFRICA
UNEMPLOYMENT INSURANCE FUND
AUTHORISATION TO PAY BENEFITS INTO BANKING ACCOUNT
To be completed by the Financial Institution (Bank/Post Office)
Name of account holder ______________________________________________________,
(Full name and surname in block letters)
Identity number
Name of Financial Institution
___________________________________________________
r B
n a
h c
o c
e d
A
c c
u o
t n
u n
m
b
r e
Indicate with an “X”
Savings account
Current account
Transmission account
Dormant:
Active
I declare that the abovementioned information is current and complete in every aspect and that the
Unemployment Insurance Commissioner will not be held liable for any incorrect payment which
might arise due to incorrect/incomplete information supplied by me.
NB:
Please note that no corrections on this form would be accepted
Information supplied by: (Name of Bank/Post Office Official)
________________________________
_______________________________
Signature of Bank Official
Bank Official Stamp
Date: ____________________
===================================================================
To be completed by the Applicant
The Unemployment Insurance Commissioner/Claims Officer
I, __________________________________________________________________________ ,
(Full name and surname in block letters)
Identity number
hereby request/instruct/authorise you to pay my benefits, if approved, into the abovementioned account
held at the Financial Institution (Bank/Post Office), unless otherwise instructed in writing.
I declare that the information as furnished by the abovementioned Financial Institution is to my
knowledge accurate and complete. I indemnify the UIC of any liability in the event of payment being
made into the provided banking account should this account be incorrect or incomplete.
_____________________________
________________
Signature of applicant
Date

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