FORM OF ANNUAL RETURN OF A COMMUNITY SCHEME

(Section 59 (b))

For office use:

Registration number : _________________________________________

All required documents attached                                                                            Yes/No

Levy paid                                                                                                                             Yes/No

COMMUNITY SCHEME PARTICULARS

Name of Scheme: .............................................................................................................................

Registration number with Service: ....................................................................................................

Registration date with Service: .........................................................................................................

EXECUTIVE SCHEME

Name

ID Number

Contact details

FINANCIALS

Audited Annual Financial Statement attached                                                                      Yes/No

Schedule of levy paid by each unit within the community scheme                              Yes/No

Total amount paid                                                                                                                               R .....................

AMENDMENT

Amendment made on the following details on the registration form

Amendment form CS A1 Attached to this return

DECLARATION

I, the undersigned authorised representative ......................................................................................................................................................(full names) Identity number ......................................................................................................................................do hereby solemnly declare that all the information contained herein is true and correct to the best of my knowledge and that I am authorised to sign this form on behalf of the Community Scheme by virtue of a Resolution dated.........................................................................................................

Signature: ............................................................................................

Date: ....................................................................................................