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MX3 Advanced Safety

Bundle Plan

1 Personal Details

2 Vehicle & Emergency Details

3 Banking Details

4 Fitment Centre

5 Online Payment

Vehicle Details | Step 2
Make
Model
Year*
Colour*
At least one of these must be completed
VIN Number
Vehicle Registration Number
Any distinguishing marks/characteristics on vehicle
Driver Details
Full Names*
Surname*
Mobile Number*
Home Number*
Work Number*
1st Emergency Contact
Full Names*
Surname*
Mobile Number*
Home Number
Work Number
Would you like to add a second emergency contact?*
2nd Emergency Contact
Full Names*
Surname*
Mobile Number*
Home Number
Work Number
Medical Aid Details
As a MX3 customer, you will have exclusive access to our Crash Alert service. In order to provide you with efficient and accurate assistance, please provide your medical aid details for us to ensure that you receive the correct medical assistance when required.
Do you have medical aid?*
Medical Aid Name*
Medical Aid Member Number*

Banking Details | Step 3
Use V2 Bank Validation API?*
Is this your bank account?*
Bank*
Account Type*
Account Holder: Initials*
Account Holder: Surname*
Account Holder: Identity Number*
Bank Name*
Branch Name*
Branch Code*
Account Type*
Account Number*
Account Holder*
Monthly Debit Order Agreement*
- I give MiX Telematics authorisation to deduct an amount of per month from my account, including an annual escalation below 8%, from this bank account for the agreed contract period.
(Credit/Cheque card required for secure online payment of )

Fitment Centre | Step 4
Please choose the most convenient fitment centre for your Matrix tracking device installation.
Province
Suburb/Town
Choose Fitment Centre
Fitment Date*

The selected fitment centre will contact you to schedule an exact time
"Congratulations on your choice of a Matrix!"

In order for us to share in your journey and remain right by your side, it is important to take note of the following before finalizing your purchase:
- Fitment bookings are only available on weekdays and exclude public holidays.
- When selecting a suitable fitment date, please take note that a fitment date will only become available two working days after date of purchase.
- We do have fitment centres that offer a mobile service at an additional fee. (Please ask your preferred fitment centre for more information.)
*
- I agree to the Matrix T's & C's

Personal Details | Step 1