Debt Review Removal Application Form

Debt Review Removal Application Form – I want to Exit Debt Review

To terminate the debt review process and to have the debt review notice removed from your credit reports requires that a court application be made for the court to find that you are not over-indebted, even if there is no court order in place for your debt review. Should you wish to terminate the debt review process, please complete the form below and attach all required documents, to allow us to do an assessment of your probable case. We shall then advise further.

Step 1 of 4

Applicant details: If you are married in community of property, both spouses must apply jointly.
Main (1st) Applicant
Title*
Initials*
Identity Number*
Full Names & Surname*
Gender*
Ethnic Group*
Marital Status*
Mobile Number*
Email Address*
Address*
Province*
Postal Code*
Owner/Tenant:*
Period at Address:*
Number of dependents
Age of dependants
Separate by commas
Next of kin full name*
Next of kin email address*
Next of kin contact number*
2nd Applicant (SPOUSE)
Title*
Initials*
Identity Number*
Full Names & Surname*
Gender*
Ethnic Group*
Marital Status*
Mobile Number*
Email Address*
Address*
Province*
Postal Code*

DEBT OBLIGATIONS
Creditors Name
Creditors Name
Who is/was your debt counsellor?*
If you were married at the time you went under debt review and the debt review application was a combined application in the name of both parties (husband and wife) made?**
Why do you want your name to be removed from Debt Review.*
Kindly Provide a Detailed Motivation for the Magistrate on why should your name be Removed from Debt Review.
The approximate date you were placed under debt review*
MM slash DD slash YYYY
Is your debt review subject to a court order?*
Approximately when last did you make payments to the Payment Distribution Agency/Debt Counselor?*
MM slash DD slash YYYY
Have you received any cancellation documentation from your debt counselor?*
Your income at the time you were placed under debt review was approximately?*
Have you settled any accounts that were placed under debt review?*
If Yes. Please remember to upload paid-up letters.
For your outstanding accounts, can you afford the original installments that were due to each account before you went under debt review?*
Are you already making payments directly to your creditors?*
Are you aware of the fact that you will no longer have protection in terms of the National Credit Act and that the creditors may proceed to enforce a credit agreement if you do not have payment arrangements with regards to any outstanding amounts?*
Upload ID Copy*
Drop files here or

Max. file size: 3 GB.
Upload Recent Payslip*
Drop files here or

Max. file size: 3 GB.
Upload Proof of Address*
Drop files here or

Max. file size: 3 GB.
Not older than 3 months. Utility bill, e.g. municipal water and lights account or property managing agent statement, Medical aid statement or policy document, etc
Upload Court Order from Previous Debt Counsellor
Drop files here or

Max. file size: 3 GB.
Upload Paid up Letters
Drop files here or

Max. file size: 3 GB.
Upload Marriage Certificate
Drop files here or

Max. file size: 3 GB.
Declaration
I agree to the following terms and conditions.
I confirm that the information contained in this document is to the best of my knowledge true and correct and further I undertake to comply with all requests from The National Debt Review Center to assist him/her to evaluate my state of indebtedness and to investigate the prospects for responsible debt restructuring. I consent to The National Debt Review Center to obtain my credit record from any/all registered credit bureaus and any other registers which may contain any of my credit information.

I/We the Consumer(s) authorise The National Debt Review Center and it’s staff and/or agents to
process, store and keep my/our personal information that has bearing to my/our debt review removal application and whilst I/we do explicitly give my/our consent to do so, I/we understand and accept that The National Debt Review Center is obliged to act within the parameters
of the Protection of Personal information Act (“POPI”).
Name
This field is for validation purposes and should be left unchanged.

Debt Review Removal Application Form

Debt Review Removal Application Form – I want to Exit Debt Review

Step 1 of 4

Applicant details: If you are married in community of property, both spouses must apply jointly.

Main (1st) Applicant

2nd Applicant (SPOUSE)

EMPLOYMENT DETAILS

Main (1st) Applicant

2nd Applicant (SPOUSE)

HOUSEHOLD LIVING EXPENSES

DEBT OBLIGATIONS