Annexure A
KwaZulu-Natal Consumer Protector |
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Form: (section 27(1) of the Act)Complaint |
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Full name(s) and surname of complainant | |
Identity number of complainant | |
Postal address | |
Physical address | |
Cell phone number | |
Land line number | |
Fax number | |
e-mail address | |
When is the best time to contact you, should this be necessary? | |
Nature of complaint | |
Provision of KZN Consumer Protection Act/National Consumer Protection Act/or Regulations promulgated under it (if known) | |
Name of business or person against whom complaint is made | |
Address of the business or person against whom complaint is made | |
Short description of complaint(if the space provided is insufficient you may attach additional pages) | |
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List of certified copies of documents relevant to complaint attached to this form(if any) | |
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What outcome do you propose for this complaint? | |
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Place | |
Date | |
Signature | |
Official Use Only |
Reference number | |
File number | |
Investigator/official responsible | |
Annexure B
KwaZulu-Natal Consumer Protector |
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Form: (section 29(5) of the Act)Notice of refusal to investigate |
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Reference number | |
Date | |
Name(s) and surname of complainant | |
Postal address | |
Fax number | |
e-mail address | |
Dear ________________________Complaint: ____________________________________________________________________________________________Date: ___________________________KINDLY BE INFORMED THAT the Office of the Consumer Protector has -(a) assessed your consumer complaint in terms of section 29(3) of the Act;(b) made a determination that you are not a bona fide consumer;(c) decided not to refer your matter to the Consumer Tribunal; and(d) for one or more of the following reasons, decided not to investigate your consumer complaint: |
| your complaint appears to be frivolous or vexatious; |
| your complaint does not allege any facts which, if true, would constitute grounds for a remedy under the KwaZulu-Natal Consumer Protection Act, 2013 (Act No. 4 of 2013), or the Consumer Protection Act, 2008 (Act No. 68 of 2008); or |
| your complaint is prevented, in terms of section 116 of the Consumer Protection Act, 2008 (Act No. 68 of 2008), from being referred to the Consumer Tribunal because more than three years have passed since -(a) the act or omission that is the cause of the complaint; or(b) in the case of a course of conduct or continuing practice, the date that the conduct or practice ceased. |
| ______________________________________________________________________________________________________________Other (provide reason) |
(mark the correct option with an X)Kindly note that you may, within thirty (30) days of the date hereof, make a request for the Review Panel to review the decision. |
Yours faithfully______________________Consumer Protector |
Annexure C1
KwaZulu-Natal Consumer Protector |
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Form: (section 29(6) of the Act)Notice of a determination that a complaint conveys the potential of criminal liability |
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Reference number | |
Date | |
Name(s) and surname of complainant | |
Postal address | |
Fax number | |
e-mail address | |
Dear __________________________Complaint: _____________________________________________________________Date: __________________________________1. KINDLY BE ADVISED THAT the Office of the Consumer Protector has made a determination that the complaint lodged against _____________________________________ (name of the business or person) conveys the potential of criminal liability; and2. FURTHER BE ADVISED THAT the Office of the Consumer Protector has, in view of the determination contemplated in abovementioned paragraph 1, reported the matter to the South African Police Service (__________________________________________ name of the station) under Case Number: ________________________________________________________ |
Yours faithfully______________________________Consumer Protector |
Annexure C2
KwaZulu-Natal Consumer Protector |
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Form: (section 29(6) of the Act)Notice of a determination that a complaint conveys the potential of civil liability |
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Reference number | |
Date | |
Name(s) and surname of complainant | |
Postal address | |
Fax number | |
e-mail address | |
Dear __________________________Complaint: _____________________________________________________________Date: __________________________________1. KINDLY BE ADVISED THAT the Office of the Consumer Protector has made a determination that the complaint lodged against ______________________ (name of the business or person) conveys the potential of civil liability; and2. FURTHER BE ADVISED THAT, in view of the determination contemplated in paragraph 1 above, the Consumer Protector intends to institute proceedings against ___________________ (name of the business or person) in the Consumer Tribunal/High Court*. (*delete that which is not applicable) |
Yours faithfully___________________Consumer Protector |
Annexure D
KwaZulu-Natal Consumer Protector |
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Form: (section 30 of the Act)Summons (subpoena) to appear before the Consumer Protector or a person in the service of the office authorised by the Consumer Protector |
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TO: ____________________________________________(Name(s) and surname of the person)Address:______________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
In the matter of the following consumer complaint:______________________________________________________________________________________________________________________________________________________________________________________________________________________________ (Provide sufficient particulars and details of the consumer complaint so that the person receiving a summons can understand the complaint)KINDLY TAKE NOTE THAT you are hereby summoned to appear before the Consumer Protector or a person in the service of the Office of the Consumer Protector, authorised by the Consumer Protector at ___________________ (place) on _____________________ (date) at _______________ (time), in order to -(a)be questioned, under oath or affirmation, in connection with the complaint stipulated above; and(b)produce and be questioned, under oath or affirmation, on the following:______________________________________________________________________________________________________________________________________ (describe books, documents or objects).FURTHER TAKE NOTE THAT–(a) you may be assisted during the examination by any person of your choice;(b) you are entitled to receive from moneys appropriated by law for such purpose, as witness fees, an amount equal to the amount which you would have received as witness fees had you been summoned to attend criminal proceedings in the High Court held in the place specified in the summons;(c) you are guilty of an offence if you, having been summoned in terms of section 30 of the Act-(i) fail without sufficient cause to attend, at the place and time specified in the summons, or to remain in attendance until the conclusion of the proceedings or until you have been excused from further attendance by the Consumer Protector; or(ii) refuse to take the oath or make an affirmation; and(d) when questioned in relation to the consumer complaint specified above, you must answer each question truthfully and to the best of your ability BUT you are not obliged to answer any question if the answer is self-incriminating; and(e) no self-incriminating, or any other, statement made to the Consumer Protector or a person in the service of the Office of the Consumer Protector, authorised by the Consumer Protector in terms of section 30 of the Act, shall be admissible in any criminal proceedings, unless you have been charged for perjury or in which you are tried for an offence contemplated in subsection 30(5) of the Act, and then only to the extent that the answer or statement is relevant to prove the offence charged. |
THUS DONE AND SIGNED AT ________________________________ ON THIS _____ DAY OF ______________, 20___._____________________________Consumer Protector |
Annexure E1
KwaZulu-Natal Consumer Protector |
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Form: (section 32(2) of the Act)Search warrant |
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To: ______________________________________ (full name(s) and surname of the Investigating Officer), with identity number: __________________, an investigation officer appointed in terms of the Act.1. This warrant authorises you to enter the following premises: __________________________________________________________________________ (description of the premises) in connection with the following consumer complaint:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(provide details of the consumer complaint)2. You are authorised to enter the abovementioned premises -(a) during business hours, that is to say between 8h00 and 17h00*;OR(b) at ___________________ (specify the hours), as hereby authorised in terms of section 32(3)(b)of the Act.*(*delete that which is not applicable)3. You are authorised to enter the abovementioned premises to -(a) inspect or search the said premises and make such inquiries as may be necessary for the purposes of obtaining information relating to the consumer complaint;(b) examine any object found on, or in, the premises which has, or may have, a bearing on the investigation in question and request from the owner or person in charge of the premises or any person in whose possession or charge that object is, information regarding the object;(c) make copies of, or extracts from, any book or document found on, or in, the premises which has, or may have, a bearing on the investigation in question, and request from any person who is suspected of having the necessary information an explanation of any entry therein; or(d) seize, against the issue of a receipt, anything on, or in, the premises which has, or might reasonably have, a bearing on the investigation in question if you need to retain it for further examination or for safe custody.4. This warrant is in force -(a)until it is executed or cancelled by a competent court; or(b)until a period of one week, from the date of issue, has expired,whichsoever occurs first.I, the undersigned __________________________________________ (name(s) and surname), in my capacity as Investigating Officer, have reviewed the evidence and am satisfied that there is a reasonable possibility that the search warrant will be issued by a judge or magistrate.________________________________________________Investigating OfficerDate: _____________________________________________________________________________Signature of Judge/ Magistrate________________________________Court stampDate: ....................................Time: ................................... |
Annexure E2
KwaZulu-Natal Consumer Protector |
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Form: (section 32(1)(d) of the Act)Receipt of seized items |
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To: ______________________________________________________________________________________________________ (full name(s) and surname and identity number of the owner or person in charge of the premises).I, _________________________________________________ (full name(s) and surname), the Investigating Officer, have seized on, or in, the premises situated at: __________________________________________________ (address of premises) and retained for further investigation, or for safe custody, the following articles:1. _____________________________________________________________________________________________________________2. _____________________________________________________________________________________________________________3. _____________________________________________________________________________________________________________4. _____________________________________________________________________________________________________________5. _____________________________________________________________________________________________________________6. _____________________________________________________________________________________________________________7. _____________________________________________________________________________________________________________8. _____________________________________________________________________________________________________________9. _____________________________________________________________________________________________________________10. ____________________________________________________________________________________________________________11. ____________________________________________________________________________________________________________12. ____________________________________________________________________________________________________________13. ____________________________________________________________________________________________________________14. ____________________________________________________________________________________________________________15. ____________________________________________________________________________________________________________(Add additional page if more space is required)___________________________________________Signature of Investigating OfficerDate: ______________________Time: __________________________________________________________________Signature of the person in charge of the premisesDate: ______________________Time: ______________________ |
Annexure F1
KwaZulu-Natal Consumer Protector |
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Form: (section 33(1) of the Act)Notice of appointment of facilitator/mediator |
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Reference number | |
Date | |
TO:Name(s) and surname of plaintiff | |
Postal address | |
Fax number | |
e-mail address | |
AND TO:Name(s) and surname of the person/business against whom the consumer complaint was lodged | |
Postal address | |
Fax number | |
e-mail address | |
Dear ______________________1. KINDLY TAKE NOTE THAT-(a) in the matter of the following consumer complaint:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Provide sufficient particulars and details of the consumer complaint)I, by virtue of the powers vested in me in terms of the provisions of subregulation 9(2) read with section 33(1) of the Act, have decided to appoint a facilitator/mediator to assist the parties to resolve the abovementioned consumer complaint by facilitation or mediation; |
(b)the details of the facilitator/mediator referred to in paragraph 1 above are as follows; and |
Name(s) and surname | |
Contact details | |
Qualifications/experience in facilitation/mediation of disputes or consumer matters | |
Other | |
(c)the details of the first meeting with the facilitator/mediator are as follows: |
Venue | |
Date | |
Time | |
2. FURTHER TAKE NOTE THAT if you have any objection to the appointment of the facilitator/mediator, contemplated in abovementioned paragraph 1, you must submit your objection to the Consumer Protector within seven (7) days of this notice.Yours faithfully______________________________Consumer protector |
Annexure F2
KwaZulu-Natal Consumer Protector |
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Form: (section 33 of the Act and subregulation 9(5))Facilitation/mediation progress report |
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Reference Number | |
Full name(s) and surname of complainant | |
Identity number of complainant | |
Postal address | |
Physical address | |
Cell phone number | |
Land line number | |
Fax number | |
e-mail address | |
Full name(s) and surname of respondent | |
Identity number of respondent | |
Postal address | |
Physical address | |
Cell phone number | |
Land line number | |
Fax number | |
e-mail address | |
Facilitator/Mediator | |
DETAILS OF MEETING(S) HELD:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
OUTCOME:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
COMMENTS/RECOMMENDATIONS (IF ANY):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
Signed at ________________________ on this ____ day of ________, 20_____________________________________Facilitator/MediatorAnnexure F3
KwaZulu-Natal Consumer Protector |
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Form: (sections 33(2) and 37(1) of the Act)Settlement agreement: Arrangement to settle a consumer complaint |
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REFERENCE NUMBER: ___________/____In the matter between:_____________________________COMPLAINANTAND____________________________RESPONDENTSettlement agreement: Arrangement to settle a consumer complaint
BE PLEASED TO TAKE NOTE that the abovementioned matter was set down for negotiations/mediation at the Office of the Consumer Protector on the_____ (day) of_________, 20____ at______________(time);FURTHER TAKE NOTE of the details of the matter at hand or in dispute;________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________AND FURTHER TAKE NOTE THAT-(a)the parties agree to resolve the dispute as follows:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________; and(b)the parties hereto WISH/DO NOT WISH* to confirm the abovementioned mediation agreement in the High Court in terms of section 33(2)(c) of the Act.(*Delete that which is not applicable)THUS DONE AND SIGNED AT ___________________ ON THIS _______ DAY OF _________, 20___________________________________________Signature of complainantFull name(s) and surname:______________________________________________________________Signature of respondentFull name(s) and surname:____________________________________________________Consumer protectorAnnexure F4
KwaZulu-Natal Consumer Protector |
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Form: (section 37(2) of the Act)Publication notice: Court order - confirmation of an arrangement to settle a consumer complaint by the High Court |
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File Reference: _________________/____In the matter between:_________________________ COMPLAINANTAND__________________________ RESPONDENTPublication of an arrangement concluded by the parties in terms of section 33(1) of the Act and confirmed by the High Court in terms of section 37(1) of the Act
KINDLY TAKE NOTE THAT-(a)the parties have entered into an arrangement to settle the consumer complaint as follows:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________; and(b)the High Court has, in terms of section 37(2) of the Act - | confirmed the arrangement; |
| confirmed the arrangement with necessary amendments; or |
| set aside the arrangement. |
(mark the correct option with an X)Please refer to the Order of the High Court attached hereto as Annexure A.THUS DONE AND SIGNED AT ________________ ON THIS _____ DAY OF ____________, 20___________________________Consumer ProtectorAnnexure G
KwaZulu-Natal Consumer Protector |
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Form: (section 34(8) of the Act)Confirmation of veracity of the complaint and indemnity |
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Reference Number | |
I, the undersigned, _______________________________________ (name(s) and surname of the complainant), in the matter of the following consumer complaint:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Provide sufficient particulars and details of the consumer complaint so that the person receiving a summons can understand the complaint)hereby-(a) confirm the veracity of the abovementioned complaint; and(b) unconditionally indemnify the Office of the Consumer Protector against any liabilities or consequences which may arise as a result of any false information or evidence furnished or adduced by myself during-(i) the lodgement and investigation of the abovementioned complaint; and(ii) the prosecution of the abovementioned complaint before the Consumer Tribunal or the High Court.THUS DONE AT AND SIGNED AT _________________ ON THIS DAY OF_____________, 20________1. _________________WITNESS2.__________________WITNESS____________________________COMPLAINANT |
Annexure H
KwaZulu-Natal Consumer Protector |
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Form: (section 21 (1)(c) of the Act)Notice of appointment of a prosecutor |
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CASE NUMBER:__________/____In the matter between:KwaZulu-Natal Consumer Protector - First Plaintiff_______________________________ - Second PlaintiffName of the ConsumerAND_______________________________ - DefendantNotice of appointment of prosecutor (Section 21(1) of Act)
TO:THE SECRETARY OF THE CONSUMER TRIBUNALADDRESS:__________________________________________________________________________________________________________________________________________________________________________BE PLEASED TO TAKE NOTE that the abovementioned matter has been set down for hearing at the Consumer Tribunal on the_______ day of_______ 20_____ at__________; andFURTHER TAKE NOTE of the following details of the prosecutor appointed in terms of section 21 (1) of the Act-(a)surname and initials:__________________________________________(b)contact details:_____________________________________________________________________________________THUS DONE AND SIGNED AT______________________ ON THIS______________ DAY OF__________, 20____________________________________Consumer ProtectorAND TO:THE SECOND PLAINTIFFADDRESS:_____________________________________________________________________________________AND TO:THE DEFENDANTADDRESS:_____________________________________________________________________________________Annexure I1
KwaZulu-Natal Consumer Protector |
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Form: (sections 35(1) and (2) of the Act)Notice: Decision not to institute proceedings/not to refer the complaint to another authority* |
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Reference number | |
Date | |
TO:Name(s) and surname of complainant | |
Postal address | |
Fax number | |
e-mail address | |
AND TO:Name(s) and surname of the person/name of the business against whom the consumer complaint was lodged | |
Postal address | |
Fax number | |
e-mail address | |
Dear ____________________________Complaint: _________________________________________________________________1. I regret to inform you that the Office of the Consumer Protector has, in respect of the abovementioned complaint decided not to-(a) initiate any proceedings in the Consumer Tribunal or High Court; or(b) refer the matter to another authority.2. The reason(s) for this decision is/are* the following:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________KINDLY NOTE: If you are aggrieved by the decision not to institute proceedings, you may-(a) within fourteen (14) days of the date hereof; and(b) by completing the Review Notice in Annexure I2,make a request for the Review Panel, contemplated in section 35(3) of the Act, to review the decision.(* Delete that which is not applicable)THUS DONE AND SIGNED AT________________ ON THIS___________ DAY OF___________________, 20________________________________Consumer protector |
Annexure I2
KwaZulu-Natal Consumer Protector |
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Form: (section 35(3) of the Act)Review notice: Review of the decision of the Consumer Protector not to refer the consumercomplaint to the Consumer Tribunal |
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File Reference: __________/____In the matter between:______________________________ — COMPLAINANTAND______________________________ — RESPONDENT |
Review notice |
TO: The Consumer ProtectorKINDLY TAKE NOTE THAT -(a) I am aggrieved by the decision of the Consumer Protector, dated ______________ 20_____, copy of which is attached hereto as Annexure A, not to refer my consumer complaint to the Consumer Tribunal. The basis for my dissatisfaction with the said decision is as follows:(if necessary attach an additional sheet)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________; and(b) I request that the abovementioned decision is referred to the Review Panel, contemplated in section 35 of the Act, for review.THUS DONE AND SIGNED AT ____________ ON THIS ______________ DAY OF ______, 20_____________________________Consumer |
Annexure I3
Kwazulu-Natal Consumer Protector
Form: (section 35 of the Act)
Review Judgement
CASE NUMBER:__________/______In the matter between:_______________________________ — COMPLAINANTAND_______________________________ — RESPONDENTReview judgment (section 35 of the Act)
PLEASE TAKE NOTE that the abovementioned matter was reviewed by the Consumer Review Panel established in terms of section 35 of the KwaZulu-Natal Consumer Protection Act, 2013 (Act No. 4 of 2013), at________________________ (place) on this___ day of__________, 20____;AND FURTHER TAKE NOTE that the following Order was made:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________THUS DONE AND SIGNED AT______________ ON THIS________ DAY OF________________, 20______________________________________Chairperson: Review panelAnnexure J1
KwaZulu-Natal Consumer Protector
Form: (sections 21 (1) and 34(1) of the Act)
Summons initiating proceedings in the Consumer Tribunal
CASE NUMBER:_____/___In the matter between:KwaZulu-Natal Consumer Protector - First Plaintiff________________________________ - Second PlaintiffName of the ConsumerAND________________________________ - DefendantSummons
TO: _____________ (THE DEFENDANT)ADDRESS OF THE DEFENDANT:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________1. TAKE NOTE THAT in the matter of the following consumer complaint:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Provide sufficient particulars and details of the consumer complaint so that the person receiving a summons can understand the complaint. If necessary attach an additional sheet)proceedings are hereby instituted against you as the person responsible for the business practice which gave rise to the consumer complaint; and2. FURTHER TAKE NOTE THAT -(a)the proceedings against you will commence before the Consumer Tribunal at___________________ (place) on the_____ day of 20____ (date), at_______ (time); and(b)an order will be sought against you on the following terms:(i) _______________________________________________________(ii) _______________________________________________________(iii) _______________________________________________________(iv) _______________________________________________________(v) _______________________________________________________(If necessary attach an additional sheet.)3. THAT the proceedings before the Consumer Tribunal will be prosecuted by the Office of the Consumer Protector, which may be represented by a prosecutor duly appointed in terms of section 21 (1)(c) of the Act;4. THAT you are entitled to appear on the stipulated date and participate in the proceedings and may be represented by an attorney, advocate or any other person;5. THAT if you intend to defend these proceedings, you must complete the form in Annexure J2, and file the Notice of Intention to Defend to the secretary of the Consumer Tribunal within seven (7) days of receipt of summons; and6. THAT if you intend to consent to the relief sought against you in the summons you may, utilising the form in Annexure J3, file a Consent to Judgement to the secretary of the Consumer Tribunal within seven (7) days of receipt of summons.THUS DONE AND SIGNED AT_____________________________________ ON THIS______________ DAY OF___________, 20__________________________________Consumer ProtectorAND TO:THE SECOND PLAINTIFFADDRESS:____________________________________________________________________________________________________________________________________________________________________________________________________________________________AND TO:THE DEFENDANTADDRESS:____________________________________________________________________________________________________________________________________________________________________________________________________________________________Annexure J2
Notice of intention to defend
CASE NUMBER:___________/_____In the matter between:KwaZulu-Natal Consumer Protector — First Plaintiff_________________________________ — Second PlaintiffName of the ConsumerAND_________________________________ — DefendantNotice of intention to defend
TO:THE SECRETARY OF THE CONSUMER TRIBUNALADDRESS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________KINDLY TAKE NOTE THAT the Defendant hereby gives notice of his or her intention to defend this action.DATED AT______________ ON THIS________ DAY OF_____________, 20_________________________DEFENDANTAND TO:THE FIRST PLAINTIFFADDRESS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________AND TO:THE SECOND PLAINTIFFADDRESS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Annexure J3
Consent to judgement
CASE NO______/____In the matter between:KwaZulu-Natal Consumer Protector — First Plaintiff________________________________ — Second PlaintiffName and surname of the ConsumerAND_________________________________ — DefendantConsent to judgment
TO:THE SECRETARY OF THE CONSUMER TRIBUNALADDRESS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________I admit that I am liable to the Second Plaintiff as claimed in the summons and I consent to the ruling accordingly.DATED AT _______________ ON THIS___________ DAY OF____________, 20______________________________DEFENDANTAND TO:THE DEFENDANTADDRESS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________AND TO:THE SECOND PLAINTIFFADDRESS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Annexure J4
Proof of service
1.I, ____________________________________ (full name(s) and surname), with identity number ____________________________________, the undersigned, hereby certify that I have served this summons upon the defendant by -(a)delivering the original copy to him or her; or(b)delivering a true copy to____________________________________ (name(s) and surname), a person above the age of 16 years, and employed at the respondent’s place of business, as the defendant could not be found.2.The nature, exigency and the consequences of this summons were explained to the recipient hereof.Place:______________________________Day:______________________________Month______________________________ 20_____________________________________Signature of recipient________________________________Signature of officialAnnexure K
KwaZulu-Natal Consumer Tribunal
Form: (section 22(1) of the Act)
Summons (subpoena) to appear before the Consumer Tribunal
TO:___________________________(Name(s) and surname of person)Address:____________________________________________________________________________________________________________________________________________________________________________________In the matter of the following consumer complaint:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Provide sufficient particulars and details of the consumer complaint so that the person receiving the summons can understand the complaint)KINDLY TAKE NOTE THAT -you are hereby summoned to appear before the Consumer Tribunal at______________ (place) on_______________ (date) at__________________ (time), in order -(a)to give evidence and be questioned under oath or affirmation in connection with the complaint detailed above; and(b)to produce and be questioned under oath or affirmation on the following:____________________________________________________________________________________________________________________________________________________________________________________(describe books, documents or objects).FURTHER TAKE NOTE THAT -(a)you are entitled to receive, from moneys appropriated by law for such purpose, as witness fees, an amount equal to the amount which you would have received as witness fees had you been summoned to attend criminal proceedings in the High Court held in the place specified in the summons;(b)you are guilty of an offence if you, having been summoned in terms of section 30 of the Act-(i)fail, without sufficient cause, to attend at the time and place specified in the summons, or to remain in attendance until the conclusion of the proceedings or until you have been excused from further attendance by the Consumer Tribunal;(ii)refuse to take the oath or make an affirmation;(iii)refuse to answer, or to answer fully and satisfactorily to the best of your knowledge or belief, any question lawfully put to you;(iv)fail to produce any book, document or object in your possession or custody or, under your control, which you are required to produce; or(v)make a false statement before the Consumer Tribunal knowing such statement to be false or not knowing or believing it to be true; and(c)you are not entitled to refuse to answer any question or to produce any book, document or object on the grounds that you would be exposed to a criminal charge: Provided that, to the extent that such answer, book, document or article does expose you to a criminal charge, no evidence thereof may be admissible in any criminal proceedings against you, except where you stand trial on a charge contemplated in -(i)paragraph (b)(iii) to (v) above, read with subsection 22(3) (c) to (e) of the Act; orTHUS DONE AND SIGNED AT______________________________ ON THIS________ DAY OF________________, 20_________________________________________Secretary: Consumer TribunalAnnexure L
KwaZulu-Natal Consumer Tribunal
Form: (subregulation 15(2))
Notice of set down
CASE NUMBER:_____/___In the matter between:KwaZulu-Natal Consumer Protector - First Plaintiff________________________________ - Second PlaintiffName of the ConsumerAND________________________________ - DefendantNotice of set down
BE PLEASED TO TAKE NOTE that the abovementioned matter has been set down for hearing at the Consumer Tribunal at______________ on the______ day of______, 20___ at______THUS DONE AND SIGNED AT____________________________ ON THIS___________ DAY OF________, 20_____________________________________Secretary: Consumer TribunalAnnexure M
KwaZulu-Natal Consumer Protector |
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Oaths and affirmations |
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WITNESS | I, _______________________ (full name(s) and surname) swear/solemnly declare upon my honour and conscience that I shall speak the truth, the whole truth and nothing but the truth, so help me God/I truly affirm.* |
______________________Signature_____________________Date |
EXPERT WITNESS | I, _______________________ (full name(s) and surname) swear/solemnly declare upon my honour and conscience that I shall state what I sincerely believe to be correct and true, so help me God/I truly affirm.* |
______________________Signature_____________________Date |
INTERPRETER | I, _______________________ (full name(s) and surname) swear/solemnly declare upon my honour and conscience that whenever I am called upon to interpret in any proceedings before the Tribunal, I will correctly interpret to the best of my ability from the language of the inquisitor to the language of the witness or deponent and vice versa, so help me God/I truly affirm.* |
______________________Signature_____________________Date |
(*Delete that which is not applicable)Annexure N
KwaZulu-Natal Consumer Protection |
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Form: (section 22(5) of the Act)Claim form for witness fees |
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Reference Number: _________________________File Number: ___________________________________________ |
A. Particulars of ClaimantSurname: __________________________________________________Name(s): __________________________________________________Identity Number: __________________________________________________Residential Address: __________________________________________________Postal Address: __________________________________________________Telephone/Cell phone number: __________________________________________________Fax number: __________________________________________________ |
Lodged by: __________________________________________________Signature: ________________________________________________ Date: _______________________ 20 _______ |
For Official UseReceived by: __________________________________________________Signature: __________________________________________________ Date: ___________ |
Approved by: ____________________________________________________________Designation: _____________________________________________________________Signature: _______________________________________________________________Date: _______________________________________________________________Authorised by: _______________________________________________________________Designation: _______________________________________________________________Payment amount: _______________________________________________________________Date of approval: _______________________________________________________________Date of payment: _______________________________________________________________ |
Annexure O
KwaZulu-Natal Consumer Protector |
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Form: (section 10(1)(f) of the Act)Adverse notations |
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Consumer Protector reference number | |
Consumer Tribunal reference number | |
Registered name of the company | |
Trading name of the company | |
Company’s registration number | |
Postal address | |
Fax number | |
e-mail address | |
File Reference:______/___In the matter between:KwaZulu-Natal Consumer Protector — First Plaintiff________________________________ — Second PlaintiffName of the ConsumerAND________________________________ — DefendantBE PLEASED TO TAKE NOTE that in the abovementioned matter, the Consumer Tribunal ordered the Consumer Protector to record the following adverse notations against the respondents herein:*1. _____________________________________________________________________________________2. _____________________________________________________________________________________3. _____________________________________________________________________________________4. _____________________________________________________________________________________5. _____________________________________________________________________________________(*Attach additional sheet if necessary)THUS DONE AND SIGNED AT _____________________ ON THIS_________ DAY OF________ 20_______________________________Consumer Protector |
Annexure P
KwaZulu-Natal Consumer Tribunal |
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Form: (section 21 (4) of the Act)Request for access to the records of the proceedings |
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CASE NUMBER:_____/___In the matter between:KwaZulu-Natal Consumer Protector — First Plaintiff/Applicant______________________________ — Second Plaintiff/ApplicantName of the ConsumerAND______________________________ — Defendant/Respondent |
Request for access to the records of the proceedings |
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Full name(s) and surname of the requester | |
Identity number of the requester | |
Postal address | |
Physical address | |
Cell phone number | |
Land line number | |
Fax number | |
e-mail address | |
TO: THE SECRETARY OF THE CONSUMER TRIBUNALI, the undersigned, request to have access to copies of the following records of the proceedings:1. ___________________________________________________________________________________2. ___________________________________________________________________________________3. ___________________________________________________________________________________4. ___________________________________________________________________________________5. ___________________________________________________________________________________(Provide the description of the record or part of the record requested)I am aware that the approval of my request to access the abovementioned record/s is subject to-(a) whether the proceedings were open to the public in terms of section 21 (1) of the Act; and(b) the payment of reproduction fees as contemplated in section 22 of the Promotion of Access to Information Act, 2000 (Act No. 2 of 2000).THUS DONE AND SIGNED AT____________________ ON THIS_________ DAY OF___________, 20_________________________________Requester |
Annexure Q1
Form: (section 31(1) of the Act)
Investigator's certificate
I, __________________________ by virtue of the powers vested in me as the Consumer Protector (in terms of section 31(1) of the Act), hereby appoint and designate -_____________________________________________Name of investigatoras investigator in terms of the KwaZulu-Natal Consumer Protection Act, 2013 (Act No. 4 of 2013).____________________________Photograph of InvestigatorTHUS DONE AND SIGNED AT__________________________ ON THIS________ DAY OF______________________, 20____________________________________Consumer ProtectorAnnexure Q2
KwaZulu-Natal Consumer Protector
Form: (section 31(7) of the Act
Investigating officer's certificate
This is to certify that:___________________________________________Identity number:__________________________ has been appointed and designated as an investigating officer in terms of section 31 (5) of the KwaZulu-Natal Consumer Protection Act, 2013 (Act No. 4 of 2013).___________________________Photograph of Investigating OfficerTHUS DONE AND SIGNED AT____________________ ON THE______ DAY OF___________ 20_________________________________Consumer ProtectorAnnexure R
KwaZulu-Natal Consumer Protector
Compliance notice in terms of section 100 of the Consumer Protection Act, 2008 (Act No. 68 of 2008)
KwaZulu-Natal Consumer Protector |
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Compliance notice in terms of section 100 of the Consumer Protection Act, 2008 (Act No. 68 of 2008) |
Name(s) and surname of person or entity to whom notice applies | |
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Date | |
Provision(s) of Act not complied with | |
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The details* of the nature and extent of the non-compliance are as follows:(*Attach additional sheet if necessary)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
The details* of any steps that are required to be taken and the period within which those steps must be taken:(*Attach additional sheet if necessary)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
The penalties/imprisonment/administrative fines that may be imposed in terms of the Consumer Protection Act, 2008 (Act No. 68 of 2008), if those steps are not taken: sections 107-113 of the Consumer Protection Act, 2008 (Act No. 68 of 2008).____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
Enquiries may be submitted to: |
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Business hours | |
Address to which objections to this notice may be submitted in the prescribed form | |
For Office Use Only |
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Recommendation | |
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Signed | |