RCIS - InvestorData Subscription Form

RICHARD CLUVER INVESTMENT SERVICES

InvestorData Subscription Form

Use this form to subscribe to the InvestorData download service. If you are already an InvestorData subscriber, please indicate this in the appropriate place.

When you submit this form it is sent directly to InvestorData for processing. The daily data mailings will begin arriving from the next working day after processing. A copy of this form is also sent to Richard Cluver Investment Services; in response we will send back a license code that will enable you to use the historical database. Note that InvestorData is NOT responsible for sending the license code.

1. Personal Information

Please complete all the fields in this section.

Initials	Surname

E-Mail

Postal Address

Telephone Numbers (please include area codes)
(H)	(W)
(Cell)	(Fax)

2. Subscription Information

	I am already an InvestorData subscriber
	If you are already an InvestorData subscriber, you still need to complete this form and submit it, but you can omit section 3 (payment information).
Data required from (date):
ShareFinder Serial Number (if known):

3. Payment Information

Ignore this section if you are already an InvestorData subscriber.

Subscription costs for private use are R1840 per year or R150 per month
Subscription costs for professional use are R4320 per year or R360 per month

Payment amount: (cheque, bank deposit, monthly or annual debit)

R

I will send a cheque

Please make your cheque payable to InvestorData CC and post it to PO Box 242, Noordhoek 7979.

Bank deposit (annual payment only)

Bank details: INVESTORDATA CC, First National Bank, Paarden Eiland, account No. 62063716834, branch code 201009. Please send the deposit slip to the above address or fax it to 086-5567468.
Please do not use this option if you intend paying monthly.

Credit Card

Name on Card:
Card Type:
Credit Card Number:
CVV Number:	(three digit number on back of card)
Exp Date:	/
Payment Type:	Budget Straight
Renew Subscription:	Monthly Annually Once Off

Monthly debit from the account below

Annual debit from the account below

Account holder's name:
Account number:
Account type:	Savings Transmission Cheque
Bank and branch:
Branch code:

I, hereby give authorization to InvestorData CC to withdraw from my account, detailed above, their Download subscription charge (as described in the "subscription form") for the subscription period for which I have applied, from the first day of every calendar month. The first of these payments to be deducted from the first day of (month and year) and to be repeated at the start of every "renewal period" (as described in Conditions of Subscription) thereafter until I supply two calendar months advance written notice of termination of this payment agreement to InvestorData CC.

4. Submit Application

I have read and understood InvestorData's Conditions of Subscription, and the information that I have supplied in this subscription form is, to my knowledge, true and correct in every respect.