Part 2 – Registered Body Corporate Organisations only (excluding franchises) If you are a registered Body Corporate Organisation, all requests must be counter signed (below) by the owner, director or head of the relevant business area. The counter signatory must submit the form and confirm they will be responsible for authorising all requests and advise of account closures Authorised by Designation Signature Date Part 3 – Please include all additional payment location codes that you require access to. Payment Trading name and address Last 4 digits of account Please enter the amount paid on each of GOC number if a location number where schedule the last two schedules you have registered Body code payment is made received from us Corporate Organisation Schedule total 1 Schedule total 2
Part 2 – Registered Body Corporate Organisations only (excluding franchises) If you are a registered Body Corporate Organisation, all requests must be counter signed (below) by the owner, director or head of the relevant business area. The counter signatory must submit the form and confirm they will be responsible for authorising all requests and advise of account closures Authorised by Designation Signature Date Part 3 – Please include all additional payment location codes that you require access to. Payment location code Trading name and address Last 4 digits of account number where schedule payment is made Please enter the amount paid on each of the last two schedules you have received from us Schedule total 1 Schedule total 2 GOC number if a registered Body Corporate Organisation
eschedules-add-plc-ophthalmic-v1-1-2.docx