AUTHORISATION FORM
Note: This Authorisation Form must be authorised by one of the following people: CEO, CFO, MD, Director, Owner, HR Executive (not HR Manager).
Declaration:
Company Name:L-Number
Linked Companies (if applicable)
Linked L-Numbers (if applicable)
Name of Authorised Signatory:
ID Number of Authorised Signatory:
Position in organisation:(e.g. CEO, MD, CFO, etc.)
Name of Employee Representative:
ID Number of Employee Representative:
Position of Employee Representative in organisation:
Name of SDF:
ID Number of SDF:
We, (print name)……………………………………………………………….………. the Authorised Signatory,
(print name)……………………………………………………….……………………..……. the duly appointed Skills Development Facilitator (SDF), and
(print name)……………………………………………………….……………………..……. the duly appointed Employee Representative, warrant that we are duly authorised to bind the above mentioned company and declare that this application for a Annual Training Report 2010/2011 and Workplace Skills Plan 2011/12 Grant in respect of the same, is a true reflection of the Skills Development Status of this organization and that the information/statements it contains are correct. We understand that Isett Seta may independently verify the information. We also understand that it is an offence in terms of section 33(b) of the Act to knowingly furnish any false information and that doing so may constitute fraud and be subject to the full penalty of the law. This organisation is up-to-date with Skills Development Levy payments to SARS. This also serves as proof that consultation has occurred between employer and employees regarding the content of this Skills Development Grant Claim. The Authorised Signatory further authorises Isett Seta to pay any amounts which may accrue to the Company/Entity into the Company’s/Entity’s account with the bank reflected below. The Company/Entity understands that the credit transfers, which it has authorised, will be processed by computer through a system known as the “ACB ELECTRONIC TRANSFER SERVICES”. The Company/Entity also understands that no additional advice of payment will be printed on the Company’s/Entity’s bank statement or any accompanying voucher. The Company/Entity may cancel this authority by giving thirty (30) days written notice to this effect, such notice to be sent by prepaid registered post.
Signature of Authorised Signatory: / Date:
Signature of SDF: / Date:
Signature of Employee Representative: / Date:
Please complete this section in full even if you have submitted banking details before. Please note that banking details are only required for the purpose of a refund.
Name of Bank / Branch
Type of account / Branch code
Account number
ATR/WSP 2011/12 Template, Version 1.0Page 1