Section 5 and 6

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
Credit Facilities
Section 5: New Credit Facilities and Limit Increases Under Credit Facilities
5.1 Value, volume of credit facilities
Indicate in this section the total value of the limits granted under all new credit facilities as well as limit increases
			Bank products	Overdraft	Credit	Garage/ Fuel	Other	Total
				Bank Account	Card	Card	Facility
New facilities limit values and limit increases
Number new facilities and limit increases
			Retail and Other Products	Store card (Furniture and  durables)	Store card (Clothing & semi durable)	Facility against insurance policies	Facility against retirement benefits	Services and Other
New facilities limit values and limit increases
Number new facilities and limit increases
5.2 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
New facilities and limit increases to HDPs
New facilities and limit increases to low income persons
New facilities and limit increases to residents in rural/low density areas
New facilities and limit increases to women
New facilities and limit increases to juristic person
New facilities and limit increases to small businesses
5.3 Income Categories - Gross monthly income of individual
		R0 - R3500	R3501-R5500	R5501-R7500	R7501-R10K	R10.1K- R15K	>R15000	Total
Rand Value
Number
5.4 Facility Limit Analysis
Average credit limit all credit facilities						Rand
						Rand
Average credit limit for Low Income Persons						Rand
Section 6: Debtors Book
					Pre-NCA book		NCA Book
Total Gross value of debtors book at period end (Excl. unearned)
Minus: 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
Rand Value
Number