I acknowledge that by accepting this Authority and Mandate I am bound by the payment terms applicable to this policy agreement. I authorise Cinagi on behalf of Infiniti Insurance Limited to draw all monthly premiums due on this policy against the above bank account on the 1st day of each month. I authorise Cinagi on behalf of Infiniti Insurance Limited to re-present a payment instruction against the above account in the event that any payment is unsuccessful to meet my obligations under or in terms of this Agreement. I authorise Cinagi on behalf of Infiniti Insurance Limited to obtain any information about me/us from any credit bureau, life assurance or credit providers' industry association or any other information related to credit history, judgement history or default history.