MONTHLY REGISTER OF TELEVISION TRANSACTIONS

Post To: New Business Dealers

Audience Services Division: Television Licences

SABC Private Bag X60

AUKLANDPARK, 2006

TEL: 330-9665/330-9666

NAME OF DEALER: ..............................

BRANCH: ...............................

ADDRESS: .................................

.................................................

.................................................

MONTH OF TRANSACTION: ..................

DEALER ACCOUNT NUMBER: .............................(9 Digit Account Number)

CONTACT PERSON: .................................

TELEPHONE NUMBER: .................................

E-MAIL ADDRESS: .................................

TOTAL NUMBER OF TV SETS (FOR THIS REGISTER: .................................

COMPLETE IN FULL:

CLIENT'S PERSONAL DETAILS

CLIENT'S TELEVISION LICENCE PARTICULARS:

DATE OF

PURCHASE

CLIENT'S TITLE INITIALS AND SURNAME

FULL RESIDENTIAL ADDRESS OF CLIENT

NO. OF TV SOLD

CLIENT'S ID

NUMBER

CLIENT'S SABC

ACCNT NUMBER

CLIENT'S TEL.

NUMBER

CELL OR E-MAIL

ADDRESS