DEALER APPLICATION FORM Date: Contact Name: Identification Type: ID, Passport, SECTION A Asylum Dealer Code: Nationality: Identification Number: Physical Address: City: Cell Number (Your Wallet will be linked to this number): Alternative Cellphone Number (For calls only): Do you have a Criminal Record: YES / NO The Applicant, whose details are mentioned above, hereby agrees to act as a Dealer/RICA Agent for Vuselelanani Telecomms CC 2008/182891/23. Further agrees to Terms and Conditions below. To this end, the RICA Agent agrees to: 1. Obtain, record and verify the following: a) 2. 3. 4. 5. 6. 7. 8. In the case of a person who requests the activation of a Sim-card and– (i) Is a South African citizen or is lawfully and permanently resident in South Africa , the full names and surname, identity number and at least one address of such person; or (ii) Is not a South Africa citizen or who is not permanently resident in the Republic, the full names and surname, identity number and at least one address of such person and the country where the passport was issued; or Be trained by and always conduct himself/herself/itself in terms of the training obtained from VUSELELANANI TELECOMMS; Comply with the requirements of the registration process as communicated to him/her/it by VUSELELANANI TELECOMMS during training or otherwise which include registrations and deregistration of pre-paid customers on a non-discriminatory basis, in a courteous and friendly manner; Not charge any customer for any registration or deregistration; That only sim cards provided by VUSELELANANI TELECOMMS are covered by this agreement; VUSELELANANI TELECOMMS may withhold earnings and/or cancel this agreement with immediate effect if it finds out that sales are fraudulent; Not perform BULK RICA registrations, which is an offence – Any Dealer/Agent found guilty of this practice will immediately have this agreement cancelled and will not be entitled to any further Revenue or Stock from VUSELELANANI TELECOMMS; Always use the correct client’s Identity or Passport document and proof of address; VT RICA AGENT AGREEMENT SECTION B Dealer/Rica Agent hereby enters into an agreement with Vuselelanani Telecomms CC. Dealer/Rica Agent understands and accepts the following: A. B. Page 1 of 2 Commissionable Criteria: The following criteria must be met before a SIM Card is recognised as commissionable, and before any commissions can be paid on that respective SIM Card. NETWORK CRITERIA Vodacom, MTN, Cell C and Hello Mobile R 30 spend by customer (excl VAT) Activation Bonus: The following commission will be paid out to VT-Agents (RICA Agents) once the SIM card has met the commissionable criteria. This is a once off commission. NETWORK ACTIVATION BONUS All networks R 12 This Agreement constitutes the entire agreement between the Parties in relation to the subject matter hereof and may only be amended by the Parties in writing and Rica Agent further confirms that the information provided in the Application form is to the best of my knowledge true and correct. Thus done and signed at ___________ _______________________________ VT Dealer/RICA Agent on this the day of 20______. _________________________________ VT Employee Send all completed Application Forms to [email protected] or Fax: 086 208 9290 with a copy of your ID, Passport or Asylum Office: 082 TELECOM | Cell: 0606 TEBOGO | Fax: 086 208 9290 www.vuselelanani.co.za © 2013 Vuselelanani Telecoms CC. All Rights Reserved. Page 2 of 2
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