Declaration
I declare as follows:
1) I undertake to comply with all requests from The National Debt Review Center to evaluate my state of
indebtedness and to investigate the prospects for responsible clearance of my name. I consent to The
National Debt Review Center to obtaining my credit record from any/all registered credit bureaus and
any other registers which may contain any of my credit information.
2) I undertake not to enter into any further credit agreements other than a consolidation agreement, with
any credit provider until one of the following events have occurred:
The National Debt Review Center rejects my application; or
The Court determines that I am still over-indebted; or
3) I undertake not to hand over any of my assets to debt collectors unless I have first discussed the
matter with The National Debt Review Center
4) I confirm that the information contained in this document is to the best of my knowledge true and correct.
5) I declare that the debt review removal process has been explained to me and I understand that:
My debt remains my responsibility and that I must continue making payments to all my credit providers
every month.
I understand and accept The National Debt Review Center Fee Structure as set out below.
I understand my debt review removal application must be finalized with a court order and I
authorize The National Debt Review Center to instruct an attorney to appear in court on my
behalf and I accept full responsibility for the settlement of the legal fees as set out below.
I understand that if I default on any obligation with credit providers, such credit providers may
then enforce, by litigation or other judicial process, any right or security they may have under my
credit agreements. I understand that I will be required to pay the instalments and interest rates
as required by my credit providers and credit providers can proceed with legal action against me
that may result in judgment being taken and repossession of my assets should I not meet these
obligations.
6) I understand that the debt review listing on my name will only be cleared after a court declares me no
longer over-indebted.
Should my application be unsuccessful any further court action will be done at my expense to clear my
name.
7) I understand that my creditors and debt counsellor might not be willing to release my account
information to The National Debt Review Center directly. I will then assist in obtaining the documents
required by Debt Review Removal SA to finalize my application.
8) I understand that there is a duty on me to inform The National Debt Review Center of any changes in
my residential address, telephone numbers, employer, and income.
9) I indemnify all employees and nominees of The National Debt Review Center against any claim that
may be instituted against it or them arising from any act or omission by such person appointed by The
National Debt Review Center or its nominee in the lawful execution of the terms and conditions of this
agreement entered into by myself, and confirm that The National Debt Review Center shall not be liable
for any damages suffered by me resulting from any act or omission of whatsoever nature, however
arising. I hereby acknowledge that all lawful actions taken by The National Debt Review Center under its
powers under this agreement are tacitly ratified by me, and I will be bound by such agreements as
principal debtor.
The National Debt Review Center Fee Structure
Fee’s payable are as follows (all amounts quoted exclude VAT):
1) An administration and legal fee payable of R6 000.00
2) Payment can be split over two, three or four months as agreed.
3) I understand that should The National Debt Review Center not be able to obtain a court date for my
case to be heard after 90 days of receiving my completed application. The National Debt Review Center
will refund me in full or in part of the fee I paid to them as set out above.
