ENTITY DETAILS

A1: Entity Name

A2: Skills Development Levy Number (SDL)

A3: Postal Address of the Main Office

City

Province

Postal Code

A4: Standard Industrial Code (SIC Code) for the main business activity

DETAILS OF THE PERSON WHO COMPLETED THE FORM

A5: Title

A6: Surname

A7: First Name

AS: ID Number

A9: Telephone Number

Al0: E-mail

BANKING DETAILS

A11: Name of Bank

A12: Account Number

A13: Name of account Holder

A14: Type of Account

A15: Branch Name

A16: Branch Code

B1: Total number of employees per occupational category, by gender, population group, disability status and age group

Occupations

Male

Female

Total

People with Disability

Age Groups

Geography

OFO

Code

Occupational

Category

A

C

I

W

A

C

I

W

A

C

I

W

<35

35-55

>55

Local Municipality

B2: Total number of employees· in each province

C1: Planned beneficiaries of training per occupational category, by gender, population group and disability status

Occupations

Male

Female

Total

People with Disability

Age Groups

Geography

OFO

Code

Occupational

Category

A

C

I

W

A

C

I

W

A

C

I

W

<35

35-55

>55

Local Municipality

OFO Code

Occupational Category

Number to be trained at

Entry level

Intermediate Level

Advanced Level

OFO Code

Occupational Category

Number to be trained at

Entry level

Intermediate Level

Advanced Level

AET

Total number to be trained

AET

D1: Number of actual beneficiaries of training per occupational category, by gender, population group and disability status

Occupations

Male

Female

Total

People with Disability

Age Groups

Geography

OFO

Code

Occupational

Category

A

C

I

W

A

C

I

W

A

C

I

W

<35

35-55

>55

Local Municipality

OFO Code

Occupational Category

Educational Institute

Number to be trained at

Entry level

Intermediate Level

Advanced Level

AET Training

Total number of employees

AET

Indicate how training as reported in the ATR, and PTR has affected the company.

Percentage of Payroll spent on training

E1: Number of planned beneficiaries of training per occupational category, by gender, population group and disability status.

Occupations

Male

Female

Total

People with Disability

Age Groups

Geography

Start Date

End Date

OFO

Code

Occupational

Category

A

C

I

W

A

C

I

W

A

C

I

W

<35

35-55

>55

Local Municipality

Occupations

Male

Female

Total

People with Disability

Age Groups

Geography

Start Date

End Date

OFO

Code

Occupational

Category

A

C

I

W

A

C

I

W

A

C

I

W

<35

35-55

>55

Local Municipality

OFO Code

Occupational Category

NQF level

PIVOTAL Programmes

Number to be trained at

Start Date

End Date

Entry level

Intermediate Level

Advanced Level

OFO Code

Occupational Category

NQF level

PIVOTAL Programmes

Number to be trained at

Start Date

End Date

Entry level

Intermediate Level

Advanced Level

F1: Number of Trained beneficiaries per occupational category, by gender, population group and disability status.

Occupations

Male

Female

Total

People with Disability

Age Groups

Geography

Start Date

End Date

OFO

Code

Occupational

Category

A

C

I

W

A

C

I

W

A

C

I

W

<35

35-55

>55

Local Municipality

Occupations

Male

Female

Total

People with Disability

Age Groups

Geography

Start Date

End Date

OFO

Code

Occupational

Category

A

C

I

W

A

C

I

W

A

C

I

W

<35

35-55

>55

Local Municipality

OFO Code

Occupational Category

NQF level

PIVOTAL Programmes

Number to be trained at

Start Date

End Date

Entry level

Intermediate Level

Advanced Level

OFO Code

Occupational Category

NQF level

PIVOTAL Programmes

Number to be trained at

Start Date

End Date

Entry level

Intermediate Level

Advanced Level

Indicate how training as reported in the ATR, and PTR has affected the company.

Percentage of Payroll spent on training

(Insert any clarification or comment that you wish to make on any aspect of the WSP, ATR and PIVOTAL Report. (Provide the number of the item that your comment refers to).

Section G of the template, with the original signatures, must be submitted to the skills development division of the relevant SETA by hand, post or fax by 30 June.

DECLARATION

We, the undersigned, submit this information in fulfillment of this entity's legal obligation in terms of the skills development legislation and regulations. We declare that, to the best of our knowledge, the information contained in this WSP/ATR/PIVOTAL Report is accurate and up to date. We recognise that any inaccurate statement in this document may constitute fraud and be subject to the full penalty of the law.

SIGNATORIES

H1: Designated Signatory

Name and Surname

Telephone Number

Original Signature

Date

The person who completed WSP/ATR/PIVOTAL Report

Designated employee representative

AUTHORISATION