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Account No. No. 2 Old Mutare Road, Msasa, Box BE 1298 Belvedere, Harare, Zimbabwe. Tel: +263-4- 486121-6, Fax: +263-4-486120, +264-4-486807 ECONET USE ONLY Sales Person Customer account number # Total Product Value Monthly Instalment (to be deducted through payroll over 10 months) USD$ Date Approvals Signatures Month for 1 st payroll deduction Approved/ Declined ………………………………………….. HR Payroll Shop Name Approved/ Declined ………………………………………….. Credit Control NB: A copy of the form should be returned to payroll for effecting monthly deductions once the approval process is complete. INDIVIDUALS Mr/Mrs/Ms…………….Name……Phillimon……………………………………...Surname……Mupinga………………………………………….. Physical address………7…Portigieter…Northvale… Bulawayo…………………………………………………………………………………………… Contact Number……+263772822021………………………………. Alternative Contact Number…… +236772800021..………………… Email address……[email protected]. ………………………………………………………………………………………….. Occupation……Senior..Field..Technician Employee Status Permanent……(yes)…………………….Contract……………………………. Employment Number……119…………………………………………………………… Next of kin……Stella…Mupinga………………………………………………….Relationship…… Spouse………………………………………………… Contact Number……0772800021…………………………………………………………………….. CONTRACT DETAILS Product required: 2*.Samsung…Galaxy…Tablet…3…10.1…P5200.Total Price $.1312.00.Monthly Instalment $.131.20................. PAYMENT DETAILS All instalments will be deducted through the employee payroll CUSTOMER PAYROLL DEDUCTION SCHEME

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Account No.

No. 2 Old Mutare Road, Msasa, Box BE 1298 Belvedere, Harare, Zimbabwe. Tel: +263-4-486121-6, Fax: +263-4-486120, +264-4-486807

CUSTOMER PAYROLL DEDUCTION SCHEME

ECONET USE ONLY

Sales Person

Customer account number

#

Total Product Value

Monthly Instalment (to be deducted through payroll over 10 months)

USD$

Date

Approvals

Signatures

Month for 1st payroll deduction

Approved/ Declined

..

HR Payroll

Shop Name

Approved/ Declined

..

Credit Control

NB: A copy of the form should be returned to payroll for effecting monthly deductions once the approval process is complete.

INDIVIDUALS

Mr/Mrs/Ms.NamePhillimon...SurnameMupinga..

Physical address7PortigieterNorthvaleBulawayo

Contact Number+263772822021. Alternative Contact Number+236772800021..

Email [email protected]...

OccupationSenior..Field..Technician

Employee StatusPermanent(yes).Contract.

Employment Number119

Next of kinStellaMupinga.RelationshipSpouse

Contact Number0772800021..

CONTRACT DETAILS

Product required: 2*.SamsungGalaxyTablet310.1P5200.Total Price $.1312.00.Monthly Instalment $.131.20.................

PAYMENT DETAILS

All instalments will be deducted through the employee payroll

I/We do hereby certify that all the information provided is correct. I/We authorise ECONET WIRELESS to use the information contained herein to process the application for a ..payroll deduction scheme. I/We hereby acknowledge that upon acceptance of this application for Payroll deduction by Econet Wireless, a contract will commence. I/We agree to be legally bound by Econet Wireless Terms and Conditions.

Customer SignatureDate..

Sales/Service Reps Signature.Date

Product

Total Value

Instalment Per Month for 10 Months

US$

US$