Section 9 and 10
National Credit
Regulator
FORM 39 STATISTICAL RETURN
1
Name of Registered Entity
2
NCR Registration Number
3
Start of reporting period
dd/mm/yyyy
4
End of reporting period
dd/mm/yyyy
Short Term Credit
Transactions
Section 9:
Credit Agreements entered
into
9.1 Value and volume
according to term
< 1 Month
1 Month
2-3 Months
4-5 Months
6 Months
Total
Rand Value
Number of Loans
9.2 Value and volume
according to size bands
R0-1000K
R1001-R2000
R2001-R3000
R3001-R5000
R5001-R7000
>R7000
Rand Value
R 5
Number of Loans
2
Average Term
R 2
9.3 Gender, Low income,
Historically disadvantaged persons, Low density
areas
Number
Rand Value
Number of applications received from HDPs
(Black, Coloured & Indian)
Number of applications from HDPs
rejected
Credit agreements entered into with
HDPs
Credit agreements entered into with low
income people
Credit agreements with residents in
rural/low density areas
Credit agreements with women
Credit agreements with juristic
persons
9.4 Income categories -
gross monthly income of individual
R0 - R3500
R3501-R5500
R5501-R7500
R7501-R10K
R10.1K- R15K
>R15000
Total
R Value
Number
9.5 Purpose of
credit
9.5.1
Housing and related
Furniture
Small business
Education
Debt Consolidation
Service
Other
Rand Value
Number
Emergency loans Analysis -Meets criteria of
definition of emergency as per NCA
9.5.2
Death/Funeral
Medical
Income loss
Loss-theft or fire
Other Emergency
Total
(7.5.1+ Emergency loans)
Rand Value
Number
Section 10: Summary of Debtors
Book
Pre NCA
NCA Book
Total gross value of debtors book at
period end (Exclude unearned)
Minus: Total provision for doubtful debt
on last day of period
Equals: Net value of debtors book on last
day of period
Number of accounts that make up the
debtors book
Rand value of write-offs during
period
Number of accounts written-off during
period
Age Analysis of the total Gross Debtors
Book (Pre-NCA and NCA book combined)
Current
30 Days
31 - 60 Days
61- 90 Days
91-120 Days
120+ Days
Total
R Value
Number