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Referral Code
Is this a personal or business application?
Please select whether this application is for a business or personal use
Company Name
Company Registration Number
VAT Number
First Name
Last Name
ID Number
Primary Phone Number
Secondary Phone Number
Email Address
Address Line 1
Address Line 2
Suburb
City
Post Code
GPS Coordinates
Package
Package Price
MonthlyR0.00
Need installation
If you do not currently have a working OpenServe fibre line then you need installation
Installation terms
Please choose wether you would like to pay the installation in one go or in two payments.
  • All at once
  • All at once
  • Over 2 months
Installation cost
Amount payable for installation
OnceR0.00
Payment arrangement
You have chosen to pay the installation over 2 months. Therefore you will pay:
2 xR0.00
Account Name
Account Number
Debit Order Start Date
Debit Date
Bank Name
  • - select a bank -
  • ABSA
  • Capitec
  • FNB
  • Nedbank
  • Standard Bank
Account Type
  • - select account type -
  • Current/Cheque
  • Savings
  • Transmission
  • Credit Card
Branch
Branch Code
DEBIT ORDER AGREEMENT
Debit order is mandatory with a 24 month agreement

I/We hereby authorize La Rochelle IT Solutions T/A Bronberg Connect (the internet service provider) to draw against my bank account with the abovementioned bank (or any bank or branch to which I may transfer my account) the sum of {total_monthly} on the {debitdate} of each and every month, commencing on the {debitstartdate}.



MANDATE



All such withdrawals from my bank account by you shall be treated by the above-mentioned Bank as though they had been signed by me personally.



CANCELLATION



I/We agree that this authority may be cancelled by me/us, but I/We understand that I shall not be entitled to any refund of amounts, which you have withdrawn whilst this Authority was in force if such amounts were legally owing to you.



ASSIGNMENT



I/We acknowledge that this Authority may be ceded or assigned to a third party if the Agreement is also ceded to that third party, but in the absence of such assignment of the Internet Service Agreement, this Authority cannot be assigned to any third party.

Do you agree to this debit order?

Upload RICA documentation

This service is subject to RICA legislation and requires the relevant documents to be included. NO APPLLICATIONS WILL BE PROCESSED UNLESS THESE DOCUMENTS ARE RECEIVED

Documents required for all applications

These documents MUST accompany all applications
Identification document
RSA ID or passport
Upload your documents...
Proof of residence
Please include one of the accepted forms of proof of residence
Upload your proof documents (max 2MB)

Documents required for business applications

These documents must accompany all BUSINESS applications
Business registration:
Include documents that proves the registration of the business
Upload your business registration documents (max 2MB)
Business verification:
Include documents that verifies the details of the business
Upload your verification documents (max 2MB)




Untitled Document



Documents for Personal and Business


Proof of residense.


Here are some examples of proof of residence for RICA. You need only submit one of these:



  • a bank statement, municipal bill,

  • cellphone or retail account (not older than 3 months),

  • existing lease, rental or credit agreement,

  • insurance policy,

  • current TV or motor vehicle license document that includes your name and residential address

  • if you live in an informal settlement you can provide a letter and/or affidavit from a school, church or retail store where you receive your post (this letter must be on an official letterhead or have the stamp of the school, church or retail store).


Identification


You can provide one of these identity documents. Driver's license is not acceptable.:



  • Green bar-coded ID document or smart ID card

  • Temporary ID certificate issued by Home Affairs

  • Passport


Documents for Business


For business applications please verify the Company details by one of the following documents:



  • Registration Documents

  • Founding Statement

  • SARS document, or other Government issued document


Verify the Company details by one of the following documents:



  • Bank Statement

  • Municipal Account

  • Telephone Account

  • TV License

  • Supplier Account



TERMS & CONDITIONS
Please read and agree to these terms and conditions
Agree to T&C
Rate your experience
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Please verify your ID number
Please enter the ID / Passport number you entered on page one