Gas Regulator Levies Act, 2002
R 385
Electronic Communications Act, 2005 (Act No. 36 of 2005)RegulationsCompliance Procedure Manual Regulations, 2011FormsForm 2 : Basic Financial Reporting Form Payment of Licence and USAF Fees |
FORM 2
BASIC FINANCIAL REPORTING FORM PAYMENT OF LICENCE AND USAF FEES
(I-ENCS, C-ECNS, I-ECS, C-ECS, I-BS, C-BS, and RPS)
This Form should be submitted in accordance with the Licence Fees, Standard Terms and Conditions, USAF Regulations and specific terms and conditions where applicable
| 1. | Licensee details |
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Licensee Name: |
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Licensee Number(s): |
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Financial Year-end: |
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Period Under Review: |
| 2. | Have the financial statements been audited? Yes/No |
| 3. | Name of Accounting Officer / Auditor |
| 4. | Auditor / Officer Contact Details |
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| 5. | Format: |
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CALCULATION OF LICENCE FEES
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REGULATED REVENUE
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R 0.00 |
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R 0.00 |
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Total Revenue as per AFS
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R 0.00 |
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REGULATED COSTS |
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R 0.00 |
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Total Costs as per Audited Annual Financial Statements |
R 0.00 |
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Revenue from Licensed Services |
R 0.00 |
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Costs from Licensed Services |
R 0.00 |
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Gross Profit |
R 0.00 |
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Payable licence fees @ 1.5% |
R 0.00 |
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CALCULATION OF USAF CONTRIBUTION |
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Annual Turnover |
R 0.00 |
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Less allowable deductions |
R 0.00 |
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USAF Fee at 0.2% of Annual Turnover |
R 0.00 |
* A licensed service is any revenue that a Licensee generates as a result of the licence issued by the Authority
| 6. | The Authority may, in the course of carrying out its obligations, request any other relevant information that may be required |
| 7. | I, .................................................................................., in my capacity as .......................................................................hereby verify that the information provided is true and correct and have been reviewed by an Auditor / Accounting Officer. |
| 8. | Signature |
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Signature
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Designation
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Date
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