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Get and Sign Dstv Form
Code:
Branch Name:
Account No.:
IS 1O
RECEIPT No.
W4 / Sesat
Type of Account: Savings
VISA
IS 7
RECEIPT DETAILS:
Master
Card
Cheque
Transmission
PVR
Other
AMOUNT PAID
XtraView
Dual View
Subscription Period
Card No.
Expiry Date
CURRENCY
Product
Months
Agent’s Signature
CVV
No.
SUBSCRIBER ACCEPTANCE
Would you like a copy of the terms and conditions?
For MultiChoice use only:
Subscriber No.
Yes
Signed At:
RF56650(v)
confirms the accuracy of the above mentioned personal...
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