Please note:

  1. Signature is required for all application forms.
  2. Please print and sign on the hard copy after clicking on the ‘Submit’ button.
  3. You may proceed to mail the completed form to our office.

Alternatively, you may print a blank form and complete them manually here.

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Name of Billing Organization (BO) : A/C No: 9223417007

BO's Customer's Name: THE SINGAPORE POLICE CO-OPERATIVE SOCIETY LTD

BO's Customer's Ref. No: ASSOCIATE

DD slash MM slash YYYY
STATEMENT OF INTENT

STATEMENT OF INTENT

  1. I hereby instruct you to process the BO's instructions to debit my account
  2. You are entitled to reject the BO's debit instruction if my account does not have sufficient funds and charge me a fee for this. You may also at your discretion allow the debit even if this results in an overdraft on the account and impose charges accordingly.
  3. This authorization will remain in force until terminated by your written notice sent to my address last known to you or upon receipt of my written revocation through the BO.

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Send us the physical form with signature.
We do not accept scan copy with digital signature.

Last Updated on March 22, 2024