Community Schemes Ombud Service Act, 2011 (Act No. 9 of 2011)

REGISTRATION OF A COMMUNITY SCHEMES

(Section 59(b)(iii))

For office use:

Registration number : _________________________________________

All required documents attached                                                                            Yes/No

Levy paid                                                                                                                             Yes/No

SECTION 1 - PARTICULARS

Any change to the details herein must be communicated to the Service by filling in Form1A.

Authorisation by the Executive Committee of the Scheme must be attached nominating the authorised person

Name of the Community Scheme: ....................................................

Type of the Community Scheme: ......................................................

Number of units within the community scheme: ..............................

Province: ..........................................................................................

Municipality: ....................................................................................

City: .................................................................................................

Suburb: ............................................................................................

Physical address: ..............................................................................

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

Telephone: ......................................................................................

Facsimile: ........................................................................................

Email: ..............................................................................................

SECTION 2 - GOVERNANCE DOCUMENTS

Please indicate which of the documents regulate management of the community scheme. Copies of the documents to be attached to the form as an Annexures. Any change to the any of the Governance documents must be communicated to the Service by submitting Form A1

(Tick applicable document):

Rules:

Constitution:

Regulations:

Memorandum of Incorporation (Articles):

Terms and condition of the Community Scheme:

Use Agreement (Share Block Schemes):

Any other governance document:

SECTION 3 - EXECUTIVE COMMITTEE

Full names

ID Number

Contact

details  (phone

numbers, addresses)

Date of appointment

Names and details of the Trustees of a Sectional Title Body Corporate, the Board of Directors of a Share Block Company or management association of the Housing Scheme for Retired Persons or trustees of an Association. Any change to the representative must be communicated to the Service by submitting Form A1 attached hereto. A copy of the Resolution appointing the Executive Committee must be attached.

SECTION 4 - MANAGING AGENT

The information must be accompanied by a registration document of the company appointed as Managing Agent. If the managing agent is am individual, close corporate or a trust, information relating to that managing agent must be provided

Company name: .............................................................................

Company registration number: ......................................................

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

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

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

Facsimile: ......................................................................................

Email: ............................................................................................

Authorised representative: ...........................................................

SECTION 5 - FINANCIALS

Copy of the audited annual financial statement must be attached annually, the community scheme must submit a return by filling in Form 18 attached hereto.

A schedule of levies payable by each unit must be attached

Annual financial statement attached: ................................................

Appointed registered Auditors: .........................................................

Banking details:

Name of Bank: ..........................................................................

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

Authorised signatory for banking: .............................................

Financial year end for the community scheme: .................................

Total levy amount paid by each unit: ................................................

(Attach a schedule of levies payable per unit)

Fidelity funds details: ......................................................................

(provide separate Annexure where necessary)

Address where the financial records are kept: .................................

SECTION 6 - AUTHORISED REPRESENTATIVE

Attach a copy of authorisation from the Schemes Executive Committee authorising the nominated representative and the signatory to the application.

This person will act as a contact person between the Service and the Community Scheme. Any changes to the particulars must be communicated to the Service by filling in Form 1A

Full names of the nominee: ...............................................................

Identity number: ...............................................................................

Residential Address: ..........................................................................

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

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

Facsimile: ..........................................................................................

Email: ................................................................................................

SECTION 7 - SOLEMN DECLARATION

I, the undersigned authorised representative ......................................

...................................... identity number ............................................

do hereby solemnly declare that all the requirements of applicable legislation or common law have been complied with in respect of the formation of the Community Scheme and the information contained herein is true and correct to the best of my knowledge.

Signature: ...........................................................................................

SECTION 8 - SUPPORTING DOCUMENTS

Either of the following documents must be attached to this application, where applicable.

Any change to the documents must be communicated to the Service by filling in Form1A