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Form DCA 07mar2013

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Zyan Zahid
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57 views1 page

Form DCA 07mar2013

Uploaded by

Zyan Zahid
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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DIRECT CREDIT AUTHORISATION FORM

(Only Originals are Accepted)


ddNo correction tape/fluid should be used on this form. Any cancellations made must be endorsed by the same authorised signatories signing
this form AND bank.

Please complete Part II, obtain your bank’s endorsement for Part III and mail the original form (fax copy not acceptable) to the
Ministry/Department/Statutory Board that you are liaising with.

Please note:
(i) If you are receiving payment as an individual, fill in your name as stated in your NRIC/FIN.
(ii) If you are receiving payment as a Singapore registered company/business/society, fill in your organisation’s name as registered with ACRA/UEN. You
may check your registered name on www.uen.gov.sg.
(iii) Leave Part III blank if you are an ACRA-registered organisation/Singapore Citizen/Permanent Resident AND you hold a bank account with
DBS/POSB/OCBC/UOB/Far Eastern Bank (FEB)/Citibank.

PART I - TO BE COMPLETED BY THE REQUESTING MINISTRY/DEPARTMENT/STATUTORY BOARD


Name of Ministry/Department/Statutory Board Vendor ID
Contact Officer Please tick one of the relevant boxes:
Contact Number New vendor record
Fax Number Update of existing vendor record

PART II – TO BE COMPLETED BY ENTITY RECEIVING PAYMENT FROM THE GOVERNMENT/STATUTORY BOARD


All fields are mandatory. Incomplete forms will not be processed.

To: ACCOUNTANT-GENERAL

Name(s) of Bank Account Holder(s):

Address

Telephone Number
Bank No. Branc Bank Account No. to be Credited
h No. Fax Number

Email Address*
Bank and Branch Name
*It is mandatory to provide the email address. Payment notification will
be sent to this email address.
(a) I/We hereby authorise the Government and Statutory Boards to credit payments due to me/us to the above account. Amounts so credited would constitute valid discharge of obligations due
to me/us.
(b) This authorisation shall continue to be in force until I/we have notified you in writing.
(c) I/We hereby request and authorise the Government and Statutory Boards to obtain confirmation/verification of information relating to me/us and/or to my/our account(s) from/with the bank
where the Account is maintained as stated in the form.
(d) In consideration of the Government and Statutory Boards acceding to my/our said request and in consideration of the Bank confirming/verifying such information pursuant to the said
request, I/we irrevocably consent to and authorise the Bank, including any officer thereof, to disclose any information whatsoever relating to me/us and to the Account as is necessary for the
sole purpose of account validation and agree that such authorisation shall survive any termination of the Account. I/We agree that this consent shall survive the termination of any of the
Account with the Bank and may be relied on and enforced as fully and effectively by the Bank as if it is addressed to the Bank.
(e) I hereby consent to the release of my updated address by the Immigration and Checkpoints Authority (ICA) to the Accountant-General’s Department for the purpose of sending the
Remittance Advice to me.

Authorised Signature(s) & Stamp as in Bank’s Record Date

PART III – TO BE COMPLETED BY BANK

To: ACCOUNTANT-GENERAL

We hereby certify that the signature(s) and other particulars as stated in Part II agree with that contained in our records.

Name & Signature of Authorised Bank Officer Date & Bank’s Official Stamp

NFS@Gov Version 1.3 (Updated as at 7 Mar 2013)

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