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Please fill the form as required and forward to *** 

Dispute Application Form  | Name and Surname |  
 | Identity Number |  
 | Cellphone number |  
 | Preferred e-mail address |  
 | Please attach your proof of identity
 | Please attach your proof of address, which is not older than three months. Ward counsellor letters are unfortunately not permissible.  
The National Credit Act at Regulation 18(4), 24(1) and Section 134 requires consent for certain credit checks and allows credit checks to be done without consent in certain other instances. The following instances require consent: 

1. Considering a candidate for employment in a position that requires trust and honesty and entails the handling of cash or finances by an employment agency or employer.
2. Setting a limit in respect of the supply of goods, services or utilities.
3. Assessing an application for insurance by an insurance company.
4. Verifying educational qualifications and employment by an employment agency or employer.
5. An application for debt review by a debt counsellor.
6. Alternative dispute resolution done by alternative dispute agent.

Please complete this form and include which enquiries are duplicated. 

  | Subscriber who made the listing | Date and time of listing
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| Submit YES that you understand that a dispute will not be logged for enquiries that do not require consent as set out in 1 to 6 above.