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Get Application Form And Cost Schedule 30032005.doc

Ess Work number Cell number Fax number Technical Contact Name: Job Title e-mail address Work number Cell number Fax number Physical address Postal address Type of D2D Service: Direct Fax Solutions Content on Demand Payment Method: Debit Order Direct Transfer . Contract Details Page 1 Debit Order Details Data 2 Data (Pty) Ltd is hereby authorised to arrange with my (the Client s) bank or building society to collect the monthly subscription and usage rate against my.

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