Form 17.1 — Notification of Debt Review Application
Form 17.1 is the prescribed notification a debt counsellor must deliver to all credit providers and registered credit bureaux within five business days of accepting a consumer's debt review application. It places the consumer formally under debt review and triggers the credit provider's obligation to issue a Certificate of Balance (COB) within 5 business days, as set out in Annexure A clause 2.2.
Form 17.1 must include the consumer's full identifying details, the date the application was received, every credit agreement disclosed by the consumer with account numbers, and the debt counsellor's NCR registration number and contact details. The form is the legal trigger for the protections in section 86 of the National Credit Act.
Field-list reconstruction (PDF page 69, the source page is a multi-column scanned form; the printable visual lives in the original PDF). The form captures the following information:
Header block: Reference Number, Date Printed, document title 'Assessment Summary (Income and Expenditure)'.
Debt Counsellor block: DC Name, NCR DC Number.
Consumer block: Full Name (First Name, Surname), ID Number, Juristic person registration number (Company / Trust / CC number where applicable).
Income table — Applicant and Partner columns: Gross Pay, Net Pay, Other Income, Total Income.
Pay-slip deductions: Pension Fund, Medical Aid, Loans, Union subscription, Insurance, UIF, Group Life, Retirement Annuity / Endowment, Garnishees / Administration Order, Funeral Policy, Other, Tax (SITE and PAYE).
Expenditure table — Original and Revised columns: Educational Fees, Family Expenses, Groceries, Home Ownership Costs / Rent, Security, Telephone, Water and Electricity, Other.
Once-off fees: Legal fees, Entertainment (paid and not yet paid), Total.
Payment escalation: agreed Date and Percentage.
Summary block: Gross Income, Statutory Deductions, Employer Deductions, Net Income, Other Income, Total Disposable Income.
Financial services and household expenditure: Available Amount, Contingency, Gross Collectable, DC Aftercare Costs, PDA Fees, Gross Debt Affordability, Credit-agreement-linked insurances, Net Debt Affordability for distribution.
Financial Services line items: Assurance, Credit Insurance, Credit Life Insurance, Medical Expenses, Pension and Risk Benefits, Other Financial Services, Total Financial Services.
List of Unencumbered Assets: Asset category (e.g. Fixed Property, Investment, Savings), Asset description / Asset address, Status (e.g. 'Up for sale', 'Notice given'), Nominal Value, Total Value.
Closing tick-box: confirmation that the client commits to selling unencumbered assets.
NDRC Practice NoteLast reviewed 2026-04
Form 17.1 is the prescribed notice that initiates debt review and freezes legal action. The form must be complete: missing the consumer ID number or the credit agreement reference makes it invalid.
Sending an unsigned 17.1, or one with a placeholder where the counsellor's NCR registration number should be, gives credit providers grounds to ignore it. We verify the registration number and signature on every dispatch.
Credit providers log the 17.1 against the account and place a debt review hold. If they do not, the timestamp on our dispatched form is what we rely on when challenging any subsequent legal action they take.
Drawn from NDRC's active case work. For your situation, see our debt counselling overview.
Cite this clause
National Credit Regulator. (2015). Annexure E — Standard Documentation, clause 2: Form 17.1 — Notification of Debt Review Application. Guideline 001/2015 (Debt Review Task Team Agreements 2010), p. 69.