Financial Management of Parliament Act, 2009
R 385
Independent Communications Authority of South Africa Act, 2000 (Act No. 13 of 2000)RegulationsICASA Compliance Procedure Manual Regulations, 2011FormsForm 5 : Tariff Reporting Form |
FORM 5
TARIFF REPORTING FORM
(I-ECS, I-ECNS, C-ECS and C-ECNS I-BS)
This Form should be submitted in accordance with the Standard Terms and Conditions Regulations.
This Form should be submitted bi-annually in accordance with the Authority's Financial Year.
| 1. | Licence information |
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Name of Licensee |
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Licence/s held |
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Registration or ID Number |
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Date submitted |
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Period under review |
2. Tariffs (All data to be provided in 'Rand' value inclusive of VAT)
2.1 Prepaid Services - Mobile Voice
RECORD OF PREPAID SERVICES PROVIDED AND ACTUAL SERVICES CHARGED DURING THE PREVIOUS SIX MONTHS
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<Insert name of prepaid tariff plan> |
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Service |
Month 1 |
Month 2 |
Month 3 |
Month 4 |
Month 5 |
Month 6 |
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General |
Billing method (per second or per minute) |
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Inclusive minutes (Value) and other benefits |
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Mobile to Mobile voice calls |
On-net (peak) |
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On-net (off-peak) |
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Off-net (peak) |
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Off-net (off-peak) |
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Mobile to fixed voice calls |
Off-net (peak) |
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Off-net (off-peak) |
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VAS Calls |
Peak |
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Off Peak |
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Mobile to Mobile video calls |
On-net (peak) |
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On-net (off-peak) |
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Off-net (peak) |
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Off-net (off-peak) |
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Mobile to fixed video calls |
Off-net (peak) |
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Off-net (off-peak) |
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Mobile to Mobile SMS |
On-net (peak) |
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On-net (off-peak) |
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Off-net (peak) |
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Off-net (off-peak) |
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Mobile to fixed SMS |
On-net (peak) |
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On-net (off-peak) |
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Off-net (peak) |
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Off-net (off-peak) |
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Mobile to Mobile MMS |
On-net (peak) |
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On-net (off-peak) |
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Off-net (peak) |
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Off-net (off-peak) |
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International mobile to mobile video calls |
Voice calls (peak) <please specify country or country grouping> |
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Voice calls (off-peak) <please specify country or country grouping> |
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International mobile to fixed voice calls |
Voice calls (peak) <please specify country or country grouping> |
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Voice calls (off-peak) <please specify country or country grouping> |
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International mobile to mobile video calls |
Voice calls (peak) <please specify country or country grouping> |
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Voice calls (off-peak) <please specify country or country grouping>
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International mobile to fixed video calls |
Voice calls (peak) <please specify country or country grouping> |
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Voice calls (off-peak) <please specify country or country grouping> |
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International mobile to mobile SMS |
SMS (peak) <please specify country or country grouping> |
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SMS (off-peak) <please specify country or country grouping> |
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International mobile to fixed SMS |
SMS (peak) <please specify country or country grouping> |
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SMS (off-peak) <please specify country or country grouping> |
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International mobile to mobile SMS |
MMS (peak) <please specify country or country grouping> |
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MMS (off-peak) <please specify country or country grouping> |
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2.2 Postpaid Services - Mobile Voice
RECORD OF POSTPAID SERVICES PROVIDED AND ACTUAL SERVICES CHARGED DURING THE PREVIOUS SIX MONTHS
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<Insert name of prepaid tariff plan>
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Service |
Month 1 |
Month 2 |
Month 3 |
Month 4 |
Month 5 |
Month 6 |
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General |
Billing method (per second or per minute)
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Connection fee
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Call Line Identity Presentation fee
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Itemised Billing fee
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Fixed monthly charge
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Inclusive Minutes (Value) and other benefits
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Mobile to Mobile voice calls |
On-net (peak)
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||||||
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On-net (off-peak)
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Off-net (peak)
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Off-net (off-peak)
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Mobile to fixed voiced calls |
Off-net (peak)
|
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Off-net (off-peak)
|
|||||||
|
VAS Calls |
Peak
|
||||||
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Off-peak
|
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Mobile to Mobile video calls |
On-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
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Off-net (peak)
|
|||||||
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Off-net (off-peak)
|
|||||||
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Mobile to fixed video calls |
Off-net (peak)
|
||||||
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Off-net (off-peak)
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|||||||
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Mobile to Mobile SMS |
On-net (peak)
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On-net (off-peak)
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Off-net (peak
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Off-net (off-peak)
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Mobile to fixed SMS |
On-net (peak)
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On-net (off-peak)
|
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Off-net (peak
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Off-net (off-peak)
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Mobile to Mobile SMS |
On-net (peak)
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On-net (off-peak)
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Off-net (peak)
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Off-net (off-peak)
|
|||||||
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International mobile to mobile video calls |
Voice calls (peak) <please specify country or country grouping> |
||||||
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Voice calls (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to fixed voice calls |
Voice calls (peak) <please specify country or country grouping> |
||||||
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Voice calls (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to mobile video calls |
Video calls (peak) <please specify country or country grouping>
|
||||||
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Video calls (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to fixed video calls |
Video calls (peak) <please specify country or country grouping>
|
||||||
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Video calls (off-peak) <please specify country or country grouping>
|
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|
International mobile to mobile SMS |
SMS (peak) <please specify country or country grouping> |
||||||
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SMS (off-peak) <please specify country or country grouping> |
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International mobile to fixed SMS |
SMS (peak) <please specify country or country grouping> |
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SMS (off-peak) <please specify country or country grouping> |
|||||||
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International mobile to mobile SMS |
MMS (peak) <please specify country or country grouping> |
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MMS (off-peak) <please specify country or country grouping> |
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2.3 Top-up Contract - Mobile Voice and Data
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<Insert name of prepaid tariff plan>
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Service |
Month 1 |
Month 2 |
Month 3 |
Month 4 |
Month 5 |
Month 6 |
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|
General |
Billing method (per second or per minute)
|
||||||
|
Connection fee
|
|||||||
|
Call Line Identity Presentation fee
|
|||||||
|
Itemised Billing fee
|
|||||||
|
Fixed monthly charge
|
|||||||
|
Inclusive Minutes (Value) and other benefits
|
|||||||
|
Mobile to Mobile voice calls |
On-net (peak)
|
||||||
|
On-net (off-peak)
|
|||||||
|
Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
|
Mobile to fixed voice calls |
Off-net (peak)
|
||||||
|
Off-net (off-peak)
|
|||||||
|
VAS Calls |
Peak
|
||||||
|
Off-peak
|
|||||||
|
Mobile to Mobile video calls |
On-net (peak)
|
||||||
|
On-net (off-peak)
|
|||||||
|
Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
|
Mobile to fixed video calls |
Off-net (peak) |
||||||
|
Off-net (off-peak) |
|||||||
|
Mobile to Mobile SMS |
On-net (peak) |
||||||
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On-net (off-peak) |
|||||||
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Off-net (peak) |
|||||||
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Off-net (off-peak) |
|||||||
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Mobile to SMS |
On-net (peak)
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On-net (off-peak)
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Off-net (peak
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|||||||
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Off-net (off-peak)
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|
Mobile to Mobile MMS |
On-net (peak) |
||||||
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On-net (off-peak) |
|||||||
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Off-net (peak |
|||||||
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Off-net (off-peak) |
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Internet |
Per MB (peak) |
|
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Per MB (off-peak) |
|||||||
|
International mobile to mobile voice |
Voice calls (peak) <please specify country or country grouping> |
||||||
|
Voice calls (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to fixed video calls |
Voice calls (peak) <please specify country or country grouping> |
||||||
|
Voice calls (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to mobile voice calls |
Voice calls (peak) <please specify country or country grouping>
|
||||||
|
Voice calls (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to fixed voice calls |
Voice calls (peak) <please specify country or country grouping>
|
||||||
|
Voice calls (off-peak) <please specify country or country grouping>
|
|||||||
|
International mobile to mobile SMS |
SMS (peak) <please specify country or country grouping> |
||||||
|
SMS (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to fixed SMS |
SMS (peak) <please specify country or country grouping> |
||||||
|
SMS (off-peak) <please specify country or country grouping> |
|||||||
|
International mobile to mobile MMS |
MMS (peak) <please specify country or country grouping> |
||||||
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MMS (off-peak) <please specify country or country grouping> |
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2.4 Prepaid and Postpaid Data
RECORD OF DATA SERVICES PROVIDED AND ACTUAL SERVICES CHARGED DURING THE PREVIOUS SIX MONTHS
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Prepaid or Postpaid
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Line Rental Fee |
Bundle name |
Bundle size |
Monthly fixed charge |
In-bundle rate |
Out-of-Bundle rate |
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2.5 Fixed and VoIP Services
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<Insert name of prepaid tariff plan>
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Service |
Month 1 |
Month 2 |
Month 3 |
Month 4 |
Month 5 |
Month 6 |
|
General |
Billing method (per second or per minute)
|
||||||
|
Connection fee
|
|||||||
|
Call Line Identity Presentation fee
|
|||||||
|
Itemised Billing fee
|
|||||||
|
Weekly rental
|
|||||||
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Monthly rental
|
|||||||
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Annual rental
|
|||||||
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Voicemail
|
|||||||
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Inclusive minutes (Value) and other benefits
|
|||||||
|
VAS Calls |
Peak |
||||||
|
Off-net (off-peak) |
|||||||
|
Fixed to Fixed video calls |
On-net (peak) |
||||||
|
On-net (off-peak) |
|||||||
|
Off-net (peak) |
|||||||
|
Off-net (off-peak) |
|||||||
|
Fixed to Mobile voice calls |
Off-net (peak |
||||||
|
Off-net (off peak)
|
|||||||
|
Fixed to Fixed SMS |
On-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
|
Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
|
Fixed to Mobile SMS |
On-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
|
Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
|
Fixed to Fixed MMS |
On-net (peak)
|
||||||
|
On-net (off-peak)
|
|||||||
|
Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
|
Internet |
Per MB (peak) |
||||||
|
Per MB (off-peak |
|||||||
|
International fixed to fixed video calls |
Voice calls (peak) <please specify country or country grouping>
|
||||||
|
Voice calls (off-peak) <please specify country or country grouping>
|
|||||||
|
International fixed to mobile voice calls |
Voice calls (peak) <please specify country or country grouping>
|
||||||
|
Voice calls (off-peak) <please specify country or country grouping>
|
|||||||
|
International fixed to fixed video calls |
Voice calls (peak) <please specify country or country grouping>
|
||||||
|
Voice calls (off-peak) <please specify country or country grouping>
|
|||||||
|
International fixed to mobile SMS |
Video calls (peak) <please specify country or country grouping> |
||||||
|
Video calls (off-peak) <please specify country or country grouping> |
|||||||
|
International fixed to mobile video calls |
SMS (peak) <please specify country or country grouping>
|
||||||
|
SMS (off-peak) <please specify country or country grouping>
|
|||||||
|
International fixed to fixed SMS |
SMS (peak) <please specify country or country grouping>
|
||||||
|
SMS (off-peak) <please specify country or country grouping>
|
|||||||
|
International fixed to mobile SMS |
MMS (peak) <please specify country or country grouping>
|
||||||
|
MMS (off-peak) <please specify country or country grouping>
|
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2.6 Pay TV subscription tariff template
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Period |
Period |
Period |
Period |
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Name of package |
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Number of channels (attach a list and short description of the channels) |
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Monthly subscription fee |
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Connection fee |
||||
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Re-connection fee |
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Fee per out-of-bundle channel(s) |
| 3. | I, .................................................................., in my capacity as ................................... hereby verify that the information provided is true and correct. |
| 4. | Signature |
|
Signature |
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Designation |
Date |
