Get Provider Eft Application Form - Sizwe - Sizwe Co

Filling out the PROVIDER EFT APPLICATION FORM - Sizwe - Sizwe Co online is an important step for ensuring that your payment information is accurately processed. This guide provides clear, step-by-step instructions to help you complete the form efficiently and correctly.

Follow the steps to complete the PROVIDER EFT APPLICATION FORM.

1. Press the ‘Get Form’ button to access the PROVIDER EFT APPLICATION FORM and open it in your preferred editing tool.
2. Begin by filling in the 'PRACTICE NUMBER' field with your specific practice identification number for accurate identification.
3. Enter the 'PRACTICE NAME' which corresponds to your organization’s official name, ensuring it matches official documentation.
4. Input the 'DATE' on which you are completing the form to maintain a proper timeline of your application.
5. In the 'BANK' field, provide the name of the bank where your practice holds an account.
6. Fill in the 'ACCOUNT NUMBER' with the complete number of your bank account to facilitate the electronic funds transfer.
7. Enter the 'BRANCH' where your bank account is maintained, ensuring accuracy in identifying the bank location.
8. Fill in the 'BRANCH CODE' of your bank, which is often used for electronic funds transfer purposes.
9. Select the 'TYPE OF ACCOUNT' you hold by checking one of the options: Current, Savings, or Transmission, according to your banking setup.
10. Provide an 'AUTHORISED SIGNATURE,' which should be the signature of an authorized individual within your practice.
11. Complete the 'TEL,' 'FAX,' and 'E-MAIL ADDRESS,' ensuring contact information is accurate for follow-up communications.
12. Input your 'CELL' number to ensure that you can be reached quickly if there are any issues or questions regarding the application.
13. Ensure that all fields are filled in completely as it is mandatory for efficient processing of your application.
14. Attach a used cheque to the completed form to provide a reference for electronic funds transfer and send it to the Administration Department at Sizwe Medical Services, PO Box 260709, Doornfontein, 2028.
15. After verifying all entries, you can save changes to keep a digital copy, download for your records, print for submission, or share as needed.

Start completing your documents online for a smoother application process.