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    SREF 01 Student Refund Application 2022

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    khutsoleutle55

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    © All Rights Reserved
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    SREF 01 Student Refund Application 2022

    Uploaded by

    khutsoleutle55
    10 views2 pages

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10 views2 pages

    SREF 01 Student Refund Application 2022

    Uploaded by

    khutsoleutle55

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    S/REFUND-01/2022

    APPLICATION FOR AN EFT REFUND

    FINANCE DEPARTMENT TEL: (012) 521-4735/4500/4317/4614


    PO Box 199, 0204 Email: [email protected]
    SIGNATORY (A): SIGNATORY (B): EFT NUMBER: EFT DATE:
    STUDENT DETAIL

    STUDENT NO: INITIALS: SURNAME: SIGNATURE:

    CONTACT NUMBERS AND EMAIL ADDRESS ADDRESS:

    PLEASE NOTE:
     NO REFUND WILL BE ALLOWED ON DEBIT BALANCES
     NO REFUND WILL BE ALLOWED ON CREDIT BALANCE WHERE THE CREDIT IS AS A RESULT OF A MERIT AWARD, POST GRADUATE BURSARY OR FUNDED BY THE
    AGREEMENT

    UNIVERSITY
     NO REFUNDS UNDER R3000.00 WILL BE PROCESSED, EXCEPT FOR A FINAL REFUND
     APPLICATION FORMS FOR FINAL REFUNDS SHOULD BE APPROVED BY FAO AND BUSINESS ADMIN, LIBRARY, STUDENT HOUSING SERVICES, ETC. FOR CLEARANCE
     AN AUTHORIZATION LETTER FROM SPONSORS SHOULD BE OBTAINED AND ATTACHED, BEFORE A REFUND CAN BE PROCESSED
     A BANK ACCOUNT CONFIRMATION LETTER SHOULD BE OBTAINED FROM THE BANK AND ATTACHED TO THE APPLICATION
     NO REFUNDS WILL BE PROCESSED DURING REGISTRATION PERIOD, REFUNDS WILL ONLY BE PROCESSED FROM MARCH.EACH YEAR.

    SPONSOR NAME SPONSOR CODE AMOUNT


    FINANCIAL AID
    BUREAU

    PREPARED BY- INITIALS & SURNAME PREPARED BY- SIGNATURE DATE

    APPROVED BY- INITIALS & SURNAME APPROVED BY- SIGNATURE

    FINAL REFUND ONLY: STAMP


    BUSINESS

    RESIDENCE STATUS IN OUT DATE OUT


    ADMIN

    APPROVED BY-INITIALS & SURNAME PREPARED BY- SIGNATURE DATE

    FINAL REFUND ONLY: STAMP


    SERVICES
    LIBRARY

    OUTSTANDING CHARGES YES NO DATE


    APPROVED BY-INITIALS & SURNAME PREPARED BY- SIGNATURE

    PAY: STAMP
    T/TYPE COST CENTRE ACCOUNT AMOUNT
    FINANCE OFFICE

    NOTE-PAYMENT
    ADVICE
    PREPARED BY-INITIALS & PREPARED BY- APPROVED BY-INITIALS APPROVED BY-
    SURNAME SIGNATURE & SURNAME SIGNATURE
    ELECTRONIC PAYMENTS –

    BANKING DETAILS

    It is our endeavour as Sefako Makgatho Health Sciences University Finance department, to


    provide an effective and efficient service. To achieve this, we need your support.

    Below please provide your banking details, to enable us to deposit the payment/ refund, into
    your account:

    Student Number

    Student Surname

    Student Initials

    Contact Number

    Email address

    Student Signature

    Date

    Bank Name

    Branch Code

    Type of Account Savings Current Other

    Bank Account Number

    Bank Stamp

    Our Ref: Mrs H.T Shole


    Department: Head Student Debtors
    Sefako Makgatho Health Sciences University
    PO BOX 199
    0204
    Tel: (012) 521-4317/4500/4735/4614
    e-mail [email protected]

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