Debt Collectors Act, 1998 (Act No. 114 of 1998)

Regulations

Regulations relating to Debt Collectors, 2003

Annexures

Annexure A : Forms

Form 1B : Application for registration as a debt collector by juristic person/company/close corporation [Regulation 2(1)]

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Form 1B

Application for registration as a debt collector by juristic person/company/close corporation

[Regulation 2(1)]

Please note:

In the case of an officer/director/member of a juristic person/company/close corporation who has in the preceding 10 years been convicted of an offence of which violence, dishonesty, extortion or intimidation is an element, this application will only be considered upon receipt of proof of exemption by the Minister for Justice and Constitutional Development in terms of section 10(2) of the Debt Collectors Act, 1998 (Act No. 11 of 1998).

2.	This form must be completed in block letters.

Please indicate:

New Registration

Transfer from other juristic person/company/close corporation

I,..........................................................................................(full names), representative of ........................................................ (name of *juristic person/company/close corporation), hereby apply on behalf of the aforementioned *juristic person/company/close corporation, for registration as a debt collector and furnish the following particulars:

A. PARTICULARS OF *JURISTIC PERSON/COMPANY/CLOSE CORPORATION

1.	Date of registration: ...................................................................................................

2.	Registration number: ..................................................................................................

(Attach a copy of identity document)

3.	Full names and identity numbers of *officers/directors/members:

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

4.	Business address: .......................................................................................................

................................................................................... Postal code ............................

5.	Postal address: ...........................................................................................................

................................................................................... Postal code ............................

6. Registered address: ....................................................................................................

................................................................................... Postal code ............................

7.	Business telephone number: ......................................................................................

8.	E-mail address: ...........................................................................................................

9.	Fax number: ...............................................................................................................

10.	Nature of business: .....................................................................................................

11.	Period in business: ......................................................................................................

12.

Are any of the *officers/directors/members on trial for an offence of which violence, dishonesty, extortion or intimidation is an element, or has any of the officers/directors/members in the preceding 10 years been convicted of such offence? *Yes/No. If so, give details and, in the case of a conviction, indicate whether an application for exemption in terms of section 10(2) has been lodged with the Minister for Justice and Constitutional Development: :

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

13.	Has any of the officers/directors/members ever in terms of section 15 of the Act, been found guilty of improper conduct? Yes/No. If so, give details:

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

14.	Has any of the officers/directors/members ever been declared or certified by a competent authority to be of unsound mind? Yes/No. If so give details:

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

15.	Is any of the officers/directors/members an unrehabilitated insolvent? Yes/No. If so, give details:

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

16.	Was the juristic person/company/close corporation or any of its officers/directors/members the holder of a debt collector's certificate which has been withdrawn? *Yes/No. If so, give details:

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

B. OTHER PARTICULARS

1.	Particulars of trust account:

Bank: ...............................................................................Branch code: .....................

Account number: .......................................................................................................

2.	Particulars of public accountant/auditor:

Full names: ...............................................................................................................

Business Address: .....................................................................................................

................................................................................ Postal code: ............................

3.	Telephone number: ..................................................................................................

4.	Financial year: .......................................... to ......................................................

I declare that the particulars furnished by me are in all respects complete and correct.

Signed at ...................................... this ................ day of .....................................20 .............

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

Signature of representative

Remarks:

1.	In terms of the Regulations relating to Debt Collectors, 2002, it is an offence to furnish false or misleading particulars or information or make a false or misleading statement.

2.	A copy of the registration certificate must be attached.

*Delete whichever is not applicable.

[Form 1B substituted by regulation 4(a) of Notice No. R. 741 dated 29 July 2005]

Debt Collectors Act, 1998 (Act No. 114 of 1998)

Regulations

Regulations relating to Debt Collectors, 2003

Annexures

Annexure A : Forms

Form 1B : Application for registration as a debt collector by juristic person/company/close corporation [Regulation 2(1)]

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