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National Credit Act, 2005 (Act No. 34 of 2005)

National Credit Regulations, 2006

Schedule 1 : Prescribed forms

NCR Form 46

 

FORM 46 : APPLICATION FORM FOR REGISTRATION AS A PAYMENT DISTRIBUTION AGENT IN TERMS OF SECTION 45 OF THE NATIONAL CREDIT ACT 34 OF 2005, AS AMENDED

 

General information

 

The applicant must submit the completed application form together with the required documentation and application fee to the National Credit Regulator.

 

PART 1 : APPLICANT'S INFORMATION

 

1. Name of applicant

 

2. Trading name of applicant

 

3. Legal status

 

3.1 private company
3.2 public company
3.3 close corporation
3.4 co-operative

 

4. Companies and Intellectual Property Commission (CIPC)/other official registration number

 

5. Date of commencement of trading

 

6. Financial year-end

 

7. Income tax registration number

 

8. Vat registration number

 

9. Which, if any, other regulated activity does the applicant engage in?

 

9.1        Banking

9.2        Insurance

9.3        Debt collectors

9.4        Financial advisory

9.5        Other (specify)

 

10. Contact detail of the applicant

 

Physical address

Postal address

Telephone

Fax number

E-mail address (if applicable)

 

11. Name of auditor/independent reviewer/compiler

 

Telephone number

Fax number

E-mail address

Practice number

Name of professional body registered with (if applicable)

 

12. Name of attorney

 

Telephone number

Fax number

E-mail address

Practice number

Name of professional body registered with

 

13. Compliance
• Does the applicant comply with protection of personal information (POPI)?
• Does the applicant comply with the payment system in South Africa?

 

 

PART 2 : EDUCATION AND EXPERIENCE

 

1. EDUCATION

 

Qualification

Year achieved

Institution that issued the qualification (attach certified copies of certificates)

 

2. EXPERIENCE

 

Name of employer / self-employed

Date of employment

Position held

Responsibilities

Contact details

 

 

PART 3 : QUESTION, CONCERNS AND COMPLAINTS

 

1. Do you have a policy in place to handle questions, concerns and complaints?

 

2. Does this policy outline your commitment to handle questions, concerns and complaints as well as your internal systems and procedures for resolving questions, concerns and complaints?

 

3. Do these internal systems and procedures ensure that questions, concerns and complaints from consumers or credit providers are treated in a timely, efficient and courteous manner?

 

4. Do you have sufficient human resources to handle questions, concerns, and complaints from consumers and credit providers?

 

5. Is your human personnel adequately trained to handle questions, concerns, and complaints?

 

6. Are you prepared to train professional employees in accordance with these Regulations?

 

7. Are your facilities accessible to consumers and credit providers?

 

 

PART 4 : DECLARATION BY APPLICANT

 

1. The applicant hereby permits the National Credit Regulator or any person authorised by the National Credit Regulator, as set out in section 50(2)(a) to enter any place at or from which the applicant conducts the registered activities during normal business hours, to conduct reasonable enquiries for compliance purposes, including any act contemplated in sections 156(1)(d) to (h) of the Act.

 

2. The applicant confirms that the information contained in this application is accurate and complete.