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OERF ESTATE - Debit Order Form
OBSERVATORY ESTATE RESIDENT FORUM
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Welcome the the OERF Community!
I hereby authorize that the amount of R 605.00 be debited from my banking account on the first day of each month and transferred to the banking account of OBSERVATORY ROAD CLOSURE 2 in respect of payment for OERF membership and associated benefits. This arrangement will remain in effect until recalled by myself in writing by sending an email to Kim Bricknell at
treasurer@obs-estate.org.za
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