Gas Regulator Levies Act, 2002
R 385
Electronic Communications Act, 2005 (Act No. 36 of 2005)RegulationsCompliance 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 period tariff plan>
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Service
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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
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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
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Off-net (peak)
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On-net (off-peak)
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VAS Calls
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Peak
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On-peak
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Mobile to Mobile video calls
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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
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Off-net (peak)
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Off-net (off-peak)
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Mobile to Mobile SMS
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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
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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
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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
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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
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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
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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 fixed video calls
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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
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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
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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
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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 period tariff plan>
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|||||
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Service
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Month 1 |
Month 2 |
Month 3 |
Month 4 |
Month 5 |
Month 6 |
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General
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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
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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 voice calls
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Off-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
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VAS Calls
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Peak
|
||||||
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On-peak
|
|||||||
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Mobile to Mobile video calls
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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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|||||||
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Mobile to fixed video calls
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Off-net (peak)
|
||||||
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Off-net (off-peak)
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|||||||
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Mobile to Mobile SMS
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On-net (peak)
|
||||||
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On-net (off-peak)
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|||||||
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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 fixed SMS
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On-net (peak)
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On-net (off-peak)
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|||||||
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Off-net (peak)
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Off-net (off-peak)
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Mobile to Mobile MMS
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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
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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
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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
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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 fixed video calls
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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
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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
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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
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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 period tariff plan>
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Service
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Month 1 |
Month 2 |
Month 3 |
Month 4 |
Month 5 |
Month 6 |
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General
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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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|||||||
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Itemised Billing fee
|
|||||||
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Fixed monthly charge
|
|||||||
|
Inclusive Minutes (Value) and other benefits
|
|||||||
|
Mobile to Mobile voice calls
|
On-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
|
Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
|
Mobile to fixed voice calls
|
Off-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
|
VAS Calls
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Peak
|
||||||
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On-peak
|
|||||||
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Mobile to Mobile video calls
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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
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Off-net (peak)
|
||||||
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Off-net (off-peak)
|
|||||||
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Mobile to Mobile SMS
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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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|||||||
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Mobile to SMS
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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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|||||||
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Off-net (off-peak)
|
|||||||
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Mobile to Mobile MMS
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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
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Per MB (peak)
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Per MB (off-peak)
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|||||||
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International mobile to mobile voice calls
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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 video calls
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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 mobile 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 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
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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
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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 MMS
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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 period tariff plan>
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Service
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Month 1 |
Month 2 |
Month 3 |
Month 4 |
Month 5 |
Month 6 |
|
|
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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Weekly rental
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|||||||
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Monthly rental
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|||||||
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Annual rental
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|||||||
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Voicemail
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|||||||
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Inclusive minutes (Value) and other benefits
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|||||||
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Fixed to Mobile voice calls
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Off-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
|
VAS Calls
|
Peak
|
||||||
|
On-peak
|
|||||||
|
Fixed to Fixed video calls
|
On-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
|
Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
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Fixed to Mobile voice calls
|
Off-net (peak)
|
||||||
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Off-net (off-peak)
|
|||||||
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Fixed to Fixed SMS
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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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Fixed to Mobile SMS
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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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Fixed to Fixed MMS
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On-net (peak)
|
||||||
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On-net (off-peak)
|
|||||||
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Off-net (peak)
|
|||||||
|
Off-net (off-peak)
|
|||||||
|
Internet
|
Per MB (peak)
|
||||||
|
Per MB (off-peak)
|
|||||||
|
International fixed to fixed video calls
|
Video calls (peak) <please specify country or country grouping> |
||||||
|
Video 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
|
Video calls (peak) <please specify country or country grouping> |
||||||
|
Video calls (off-peak) <please specify country or country grouping> |
|||||||
|
International fixed to mobile SMS
|
Voice calls (peak) <please specify country or country grouping> |
||||||
|
Voice calls (off-peak) <please specify country or country grouping> |
|||||||
|
International fixed to mobile video calls
|
Video calls (peak) <please specify country or country grouping> |
||||||
|
Video calls (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> |
||||||
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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)
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| 3. | I, ......................................................................., in my capacity as ...............................................................hereby verify that the information provided is true and correct. |
4. Signature
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Signature
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Designation
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Date
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