HomeChoice Sales Agent Order Form made available by Anga Jubase with Agent Number 351839

1. Pensioner n
Employment details
Employer/Company name Work tel no. Self-employed n
Position/Occupation Time spent in current job?
Sales Agent details (Please supply all your Agent details here)
First name Surname
Customer’s details
account number (if they have one)
Title Full name Surname
ID no. Date of birth
Street address for parcel delivery Postal code
Postal address Postal code
Home tel no. Cell no. Email
Details of a friend or relative not living with you
Title Full name Relationship
Home tel no. Cell no. Alternative no.
SALES AGENT customer registration and order form
Choose your preferred payment method
below (Mark with an X)
Code Product name / set description Size Col Qty 6x
months
12x
months
16x
months
Cash
Choose your preferred payment method
below (Mark with an X)
Code Product name / set description Size Col Qty 6x
months
12x
months
16x
months
Cash
142059
Full terms and conditions are available at homechoice.co.za and on the reverse side of this page. The instalments advertised include the interest charges of 21.00%, delivery fees of 9% of cash price (11% on furniture
items and large appliances) and a facility account fee. Customers from Swaziland, Lesotho, Botswana and Namibia pay an extra international delivery fee. Note that we also charge a monthly service fee (currently up to
R39) to your account. New customers will be charged an account opening fee (currently R100 including VAT). These are not included in the advertised instalment. Charges and fees will never exceed the limits prescribed
by the NCA. A Pre-Agreement & Quotation will be sent to you in an SMS. Please note that we will require documents, such a 3 months’ payslips or bank statements, to validate your income for new credit accounts.
Call 0861 422 4368 (outside SA +27 21 680 1085), fax +27 21 680 1140,
email salesagents@ , WhatsApp 078 400 2142 (RSA),
free SMS call back 36750 (RSA) 36666 (Lesotho) 45678 (Namibia)
Sales Agent number
Cash or credit card payments
Upon receipt of this order, we will send the customer an SMS with the amount, due date and pay point information. The full amount must be paid as a bank deposit or EFT into the following bank
account: FNB, Account No. 50050221924, Branch code 204109, before the goods will be dispatched. For faster processing, call 0861 422 4368 to receive a cash payment reference number
before submitting the order form. This reference number must be filled in by the customer when making a cash deposit or credit card payment.
Sales Agents may not receive cash on behalf of customers.
Bank account details (These details are compulsory and must be completed)
Account holder’s full name______________________________________________ Bank ______________________________________________
Account number__________________________________ Account type_____________________________Branch code ______________________
To open an account with homechoice you need to supply proof of income. If you bank with Nedbank, Standard Bank or ABSA, they can, with your permission, send us 3 months’ bank statements, at no cost to you.
I give homechoice permission to request 3 months’ bank statements from my bank.
I give homechoice permission to debit my account on the day of each month.
Income details
Gross monthly income from your main job before any deductions: R
Net monthly income that gets paid to you every month: R Pay day (Day of month)
Monthly income from other sources: Social Grants/Maintenance R Allowance from husband/wife/family R
Commission/Overtime R Selling products/goods R
Rental income R Second job R
Date
Customer Signature
My signature confirms my order and serves as
confirmation that my income covers all my living
expenses and credit commitments, and that I will
provide all necessary documents as proof of this.
SalesAgents
account number (if they have one)
Necessary monthly living expenses
Total monthly living expenses*: Food R Accommodation R Transportation R
Water and electricity R Education R Medical R
Maintenance R Other R
If you wish to receive any of the following, please tell us by ticking the relevant box.
Would you like the homechoice Group to inform you about special, time-limited offers on weekends and public holidays? YES NO
If you do not wish to receive any of the following, please tell us by ticking the relevant box:
homechoice Group offers by: Phone SMS Email Offers from other select suppliers NO
Second choice: if your first option is out of stock
Please fill in your order here
What time would you like us to call you to confirm your order?
(*Excludes Credit Card, Bond, Car Loan
Repayment, Medical Aid payments)
3 5 1 8 3 9
JUBASE
ANGA

2. SA’s no.1 home-shopping retailer
These terms and conditions (terms) govern your
homechoice (homechoice or we or us) credit facility
(credit facility) which will apply to all credit purchases of
goods or services from homechoice under the facility.
1. Introduction
We have made a credit facility available to you so that you can
pay for goods and services purchased from us on credit over a
manageable period of time, without entering into a new credit
agreement each time you want to buy from homechoice. New
customers opening a facility will be given a pre-agreement
statement and quotation (quotation) setting out all the
specific details of your credit facility (including the interest rate
applicable, the facility limits, any fees and charges, payment
terms and other important financial information). The quotation,
together with these terms, will be the credit agreement
(agreement) that applies to all purchases through the credit
facility. homechoice provides different channels for you to
enter into the agreement and purchase from us, including
electronic and telephonic channels. Where applicable, the
agreement is subject to the National Credit Act No. 34 of 2005
(National Credit Act), as amended or replaced from time to
time. Please carefully read both the quotation and these terms
to properly understand the implications, risks, obligations and
costs of using the credit facility. If you have any questions
about the agreement please contact us by calling
0861 466 324 or emailing contact@homechoice.co.za.
2. Credit limits
Before you can enter into an agreement with us for the first
time, we conduct an affordability assessment to determine the
appropriate credit limits that can apply to your credit facility,
with reference to the requirements of the National Credit Act.
We will assign a current credit limit and a maximum credit
limit to your facility, based on the information you provided us,
your credit and risk profiles and subject to the provisions of the
National Credit Act.
In practice, the credit limits work as follows:
• The maximum credit limit is the maximum amount that
you can purchase for in line with the calculated affordable
monthly repayments. However, in order to engage in
responsible lending practices and build lasting customer
relationships, we may initially provide a lower current credit
limit to you.
• The current credit limit is your actual credit limit with us
at any given time, and may be a lower amount than the
maximum credit limit in accordance with your risk profile
as we determine in terms of our internal credit policy.
We may refuse to authorise a purchase transaction if you have
exceeded your current credit limit. We may, in our discretion,
increase your maximum and/or current credit limit temporarily
if you have requested this increase, to purchase goods or
services that would result in your credit limit(s) being exceeded.
If we ever accept a purchase of goods that results in you
exceeding your credit limit(s), it does not mean that we have
extended your credit limit(s) on any permanent basis and the
credit limit(s) that applied before the requested temporary
increase will be reinstated once the outstanding balance
is below the credit limit(s) that applied before the increase,
subject to the National Credit Act. You must inform us if you
experience a change of circumstances that negatively affects
your ability to repay your credit facility, or if the information
provided to us in your affordability assessment is no longer
accurate. Increasing your credit limit: we may increase the
current credit limit applicable to your credit facility up to the
maximum credit limit in our discretion and without notice. Your
maximum credit limit may be increased with your consent or
at your request, subject to the requirements of the National
Credit Act. We may apply an automatic annual increase of your
maximum credit limit if you agreed to the automatic increase.
Reducing your credit limit: you may at any time reduce your
maximum credit limit by sending us a request and making
payment of any amount outstanding on your credit facility that
exceeds the revised maximum credit limit, and we will action
this request within 30 days from receipt of the instruction. You
are ultimately responsible for managing your credit limits.
3. Accessing and using the credit facility
We may provide you with a secure account login through
our website, and you may be able to access your credit
facility through that secure account login. If you use the login
function, you accept complete responsibility to keep these
details, usernames and passwords safe and confidential, and
you must inform us immediately if there has been, or if you
suspect, any breach of security or confidentiality.
By agreeing to these terms you declare that:
• you have given full and true information about all personal,
financial and account details;
• you have not applied for an administration order, and you
are not currently undergoing debt counselling or debt
review;
• you have disclosed all information necessary for us to
undertake an accurate affordability assessment;
• the proposed credit limits and repayment terms in this
agreement will not cause you to become over-indebted;
and
• you will immediately inform us if circumstances change
that result in any of the above declarations no longer
being true and correct whilst you have access to the credit
facility.
You may not give permission to any other person to use your
credit facility on your behalf – your credit facility is personal to
you. Any return, refund or repair in respect of goods purchased
will be dealt with in terms of our separate return and refund
policy. If goods are validly returned for a refund after being
purchased using the credit facility, the credit facility will be
credited with the amount of the refund. Subject to any returns,
ownership of the goods will pass to you immediately upon
receipt by homechoice of a portion of the purchase price. Risk
in the goods, transfers to you on delivery of the goods. Unless
the contrary is proved, a delivery note shall constitute proof
of delivery. Each time you use the credit facility to purchase
goods or services, you agree and understand that we will debit
your credit facility with the amount of the purchase. If you use
the credit facility outside the Republic of South Africa you must
comply with all relevant exchange control regulations. It is your
duty to know the content of and comply with those regulations.
4. Interest, fees and charges
The interest rate that applies to the agreement is a variable
yearly interest rate that is linked to the South African repo rate
and the formula determined by the National Credit Act, and
will go up or down as this rate or formula changes. We will
notify you of changes to your interest rate on your statement.
Interest will be calculated and capitalised on the last day of
each month, based on the daily outstanding balance on your
credit facility. You enter into the agreement on the basis that
we may charge an initiation fee and a monthly service fee up
to the maximum fees allowed for these in terms of the National
Credit Act. We may in our sole discretion decide to lower these
fees from time to time for certain periods as we determine,
but will at all times be entitled to charge the maximum fees.
homechoice will provide written notice of any changes –
which may be delivered electronically. Instead of charging the
full initiation fee upfront and the full maximum monthly service
fees at the end of each month, we may structure the initiation
fee and a part of the monthly service fee as a “facility account
fee”. The service fee component of this fee is levied as an
annual fee. This facility account fee is levied on the day that
you enter into the agreement, and although due and payable
on this day, the facility account fee is only charged to your
account as and when you purchase – on a pro-rata basis
up to a maximum of 15% of the total purchase price of the
goods and services. The facility account fee will not exceed
the maximum fees allowed under the National Credit Act.
To the extent that the total annual facility account fee has
not been charged to your facility account in each 12-month
period, the shortfall that was due and payable during the
preceding 12 month period will be carried over to the following
12-month period and continued to be charged to your facility
account on the pro-rata basis set out above – up to 15%
of the purchase price of goods or services with each next
purchase. A once-off account opening fee will be charged
on the day that you open your facility account and will be
added to the outstanding balance. This fee is not in addition
to the fees allowed in terms of the National Credit Act and will
be deducted from the total facility account fee that we can
charge. Please note that even though the total facility account
fee (initiation fee, account opening fee and annual service
fee component) is levied on the date that you enter into the
agreement, you will not be paying any interest on the portion
of the fees not added to your outstanding balance in terms of
the pro-rata payment arrangement referred to above. It is very
important that you understand that the combined fees charged
(monthly service fee and facility account fee which in effect is
a combination of the initiation fee, account opening fee and a
portion of the service fee levied annually) will never exceed the
maximum fees as allowed in the National Credit Act and all
fees and charges will be disclosed in your quotation or other
written confirmation. If you go into arrears with your monthly
payments, and we choose to enforce this agreement, you
will be liable for all default administration charges, collections
costs, tracing costs, collections commissions, attorney costs
and other reasonable expenses incurred by us in this process,
subject to applicable laws. We will not collect or attempt to
collect any amounts for costs exceeding those permissible in
South African law.
5. Credit life insurance
We may at any time during the course of the agreement and
in our sole discretion decide that Account Balance Protection
Insurance is a mandatory condition of the agreement. If you
are not prepared to agree to Account Balance Protection if we
introduce it, you will not be able to make further purchases on
your facility account. If we introduce the mandatory Account
Balance Protection, we will provide you with the terms of the
policy and you will be bound by it, including the obligation to
pay the monthly premiums which we will debit to your account.
You also have the option to substitute it with your own
insurance policy that will provide similar cover to us. In this
instance we need to be satisfied with your policy and we must
be listed as the loss payee in terms of the policy. The cost of
credit life insurance will not exceed the maximum allowed in
terms of the National Credit Act.
6. Statements
We will send you a monthly statement of account (statement)
if there is an amount due in respect of the credit facility by
delivering this statement to the physical, postal or email
address you provided to us. The statements will set out the
balance owing under the credit facility as at the statement
date, the minimum monthly payment due and the due date
for such minimum payment. The balance owing will comprise
of the cost of your facility purchases, as well as any agreed
interest, fees and charges, less any payments received from
you. If you would like to lodge a dispute in respect of your
account statement, you must inform us within 30 days of
the statement date. If you are not receiving your account
statements, you must bring this to our attention, otherwise we
will be entitled to assume that statements are being received
and accepted.
7. Payments
You agree to pay at least the minimum payment due each
month (as reflected in your statement) without set-off or
deduction of any kind, on or before the payment due date
and without condition. All payments will be applied by us
firstly to satisfy any due or unpaid interest, secondly to any
due or unpaid fees, costs or charges, and thirdly to reduce
the amount of the outstanding balance on the credit facility.
Our approved payment methods will be listed in your
statement. If you choose to make payments by debit order, the
minimum due payment will be taken from your bank account
automatically each month, on the date that you have chosen
in terms of the debit order mandate. If the date that you have
chosen falls on a weekend or public holiday, the debit may
be processed on the last business day before the Sunday or
public holiday. We reserve the right to track the nominated
bank account and present the instruction for payment as
soon as sufficient funds are available in the nominated bank
account to ensure successful payment from the due date or in
terms of your debit order mandate. If you make any payment
by transfer or direct deposit, you are responsible for ensuring
that the correct reference number is used for that payment,
so that we can allocate it correctly in our system to your credit
facility. If your credit facility is in arrears (meaning you have
failed to make any minimum payment when due), you may
not be allowed to transact further on your credit facility. You
are not entitled to defer payment or refuse to make payment
of amounts payable by you on the basis that you have an
outstanding claim or query regarding our service to you.
8. Default and termination
We may terminate the agreement where the law allows us to
terminate it. You may at any time terminate the credit facility
by paying the full balance outstanding on the credit facility and
requesting us in writing to terminate this agreement.
In the event of:
• your failure to make a minimum payment when due;
• your failure to comply with any term of the agreement;
• your estate being sequestrated; or
• your death,
then:
• homechoice may suspend access to your credit facility
without notice;
• homechoice may draw the default to your notice and
propose that you refer the credit agreement to a debt
counsellor, alternative dispute resolution agent, consumer
court or ombud with jurisdiction, with the intent that
the parties resolve any dispute under the agreement or
develop and agree on a plan to bring payments under
the agreement up to date. (Note that if you have been in
default for at least 20 (twenty) business days and at least
10 (ten) business days have lapsed since homechoice
sent the notice to you and you have not responded to
the notice, or have responded by rejecting homechoice
proposals, homechoice may approach a court for an
order to enforce the agreement.)
You may, at any time before we have cancelled the agreement,
re-instate the agreement that is in default by paying to us
all amounts overdue, together with our permitted default
charges and reasonable costs of enforcing the agreement up
to the time of re-instatement. If at any time the credit facility is
terminated, the full amount owing to us in respect of that credit
facility will immediately become due and payable. If you have
a credit balance on the credit facility, the credit balance will be
paid by us into an account nominated by you. The termination
of this agreement will not affect any liabilities or obligations
which are intended to survive termination, including, without
limitation, confidentiality, payment and indemnification
obligations which arise pursuant to this agreement. A certificate
issued and signed by one of the directors of homechoice stating
the amount owing by you is prima facie (meaning accepted until
proven otherwise) proof of the facts stated therein and may be
used in support of any court proceeding.
9. Early settlement
You are entitled to settle the full balance owing under the credit
facility at any time, with or without advance notice to us. If
you want to pay the full balance owing before the due date
for payment, you may request us to provide you with an early
settlement figure. We will provide you with a figure that will be
valid for the period that we specify. If you decide to pay this
early settlement figure, you must ensure that we receive this
payment on or before the date that we specified.
10. Unauthorised purchases
You undertake to notify us in writing of any query or concern
regarding the correctness of a monthly statement or purchase
details within 30 days of the date of that particular occurrence.
We will not hold you liable for any unauthorised purchases if
you properly notified us within this time period, unless we can
establish that you authorised or were responsible for such
purchase.
11. Confidentiality and Credit Bureau
We recommend that you familiarise yourself with our privacy
policy which is accessible through the homechoice website.
You understand and agree that we may request and receive
any of your confidential and consumer credit information from
any credit bureaus, other register or any third party at any time,
including requesting a bureau score. You further confirm that
this consent also covers information already received by us.
You also acknowledge that we may register information
about the conduct of your account with any credit bureau
registered in South Africa. Such information may be used by
us and other members of the credit bureau to make credit
decisions in relation to you or members of your household, to
prevent fraud and to assist in the tracing of debtors. You are
entitled to contact any credit bureau and request that your
credit information be disclosed to you, and may challenge
any information held by such credit bureau that you believe
to be incorrect. We and/or our authorised agents and service
providers will be entitled to monitor and record telephone
conversations that take place between you or any authorised
person, with any homechoice employee or agent. Any
data about you to which we become entitled in terms of this
agreement can be made available to any prospective purchaser,
or transferred to any third party, should we decide to sell our
business, or such third party obtains control over homechoice.
12. Marketing options
You have the right to be:
• excluded from any telemarketing campaigns that may be
conducted by or on behalf of homechoice;
• excluded from marketing or customer lists that may be
sold or distributed by homechoice; and
• excluded from any mass distribution of email or sms
messages.
You are entitled at any time to contact us and request that the
options selected by you in relation to marketing be affected
or amended.
13. Choice of law and disputes
This agreement, the credit facility, and the purchase of any
goods or services from homechoice, shall be governed in all
respects by South African law. You consent to the magistrate’s
court having jurisdiction in respect of all legal proceedings
connected to this agreement, notwithstanding that the value
of the matter in dispute might exceed the jurisdiction of the
magistrate’s court. Disputes regarding this agreement can be
raised through the homechoice contact centre at
0861 466 324 and by sending a written notice to homechoice.
The National Consumer Tribunal can also be contacted at
012 683 8140/012 742 9900 should resolution of a dispute
not be reached with us or if you want to lodge a complaint at
any time.
14. Legal acknowledgements
If you are married in community of property, you hereby
confirm that you have obtained the written permission of
your spouse to enter into the agreement, and to accept any
increase to the credit limit in accordance with this agreement.
We will give you notice of possible delays affecting any service
offered by us in connection with the credit facility. You accept
that sometimes our servers may be down, or we may be
experiencing other technical difficulties, and we do not accept
any liability for direct, indirect or consequential loss suffered
by you arising from any system malfunction, failure or delay
in our service. We will not be held responsible for any loss or
damages (direct, indirect, or consequential) you may suffer for
whatsoever reason arising from this agreement, or your use
of the credit facility. You hereby confirm that the state of your
indebtedness was not under evaluation or debt review by a
debt counsellor at the time of entering into this agreement.
15. Notices
You acknowledge that we will be entitled to contact you,
and send statements to, the address chosen by you in your
quotation, and undertake to immediately advise us of any
change to your contact details (including but not limited to
business, postal or residential addresses, any telephone
number or email address). You agree that any notice in terms
of section 129 of the National Credit Act may be delivered to
you by registered mail at your residential address given to us
on entering into the agreement.
Our full details and address for the purposes of this agreement
are as follows:
homechoice (Pty) Ltd
NCR no: NCRCP 454
78 Main Road, Wynberg, 7800
Tel: 0861 466324 Email: contact@homechoice.co.za
The address chosen by you in the quotation shall be your
address for service of all notices, processes, statements and
correspondence to be sent.
A written notice or communication actually received by either
of us shall be an adequate written notice or communication
notwithstanding that it was not sent to or delivered at a chosen
address.
16. General
If we grant you any indulgence, it will not be a waiver of any of
our rights in terms of this agreement. This means that even if
we allow any deviation from this agreement, we still have our
rights under this agreement if we want to exercise our rights.
You may not cede any of your rights under this agreement
without our prior written consent. We will be entitled, without
your knowledge, to cede/transfer and delegate our rights and
obligations in terms of this agreement to any third party.
We will deal with all returns and refunds of goods in terms of
our standard returns policies. Any provision in this agreement
which is or may become illegal, invalid or unenforceable in
any jurisdiction affected by this agreement shall, as to such
jurisdiction, be ineffective to the extent of such prohibition or
unenforceability and shall be severed from the balance of this
agreement, without invalidating the remaining provisions of
this agreement or affecting the validity or enforceability of such
provision in any other jurisdiction. We may amend these terms
in future, which we will do by giving 5 days' notice to you of
this change (sending this notice to the address chosen by you
in the quotation). If you do not agree with any amendments,
you have the right to terminate this agreement and cancel
your credit facility by paying the full outstanding balance on
such credit facility in terms of this agreement. These terms and
conditions are available in English, Afrikaans, isiZulu, isiXhosa
and Sesotho.
Terms and conditions
Your buying rights are protected
142059
OTHER EASY PAYMENT OPTIONS
ATM Add homechoice as a recipient and pay at any ATM. R7.40 charge
Bank Pay inside FNB, ABSA or Standard Bank while you do your banking. R7.40 charge.
Shops Pay while you shop at Checkers, Shoprite, Pick ’n Pay, Foodworld, PEP, Spar and
selected stores displaying the EasyPay or Pay@ logos. R7.40 charge.
Post Office Pay at any South African post office. R7.40 charge.
Please note: cheques are not accepted as payment. Don’t pay anyone from our home-delivery service!
FREE WAYS TO PAY FOR YOUR ORDER
Debit Order Make your life easier by having your monthly instalments taken off
your bank account automatically. It's free of charge (RSA only).
Credit Card Simply call us and pay with your debit, cheque or credit card.
This payment method is also free of charge.
Online Log onto your bank’s website and choose homechoice from the list of
pre-approved recipients. it’s hassle-free, always on time and free of charge.
Call 0861 466 324 for more information (Customers outside South Africa,
call +27 21 680 1300).
Pay with cellphone Simply call 0861 466 324 with your
banking details and we’ll set it up for you.
Or do it yourself on KwikServe at any time of day or night. Simply dial
*120*466324# on your cellphone and follow the easy steps to set up
your account.
Please note: You'll be charged 20c per 20 seconds by your network provider when
you use KwikServe. KwikServe is currently only available to South African cellphone
users but will soon be coming to Namibia and Botswana.