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Tracking No. Client No. Application No. Application Approval Reason for Application Rejection N Y THE ABOVE FOR OFFICIAL USE ONLY TO BE COMPLETED BY Cell C ONLY CST CHANGE OF OWNERSHIP APPLICATION FORM A. APPLICANT GENERAL INFORMATION Where indicated with an asterisk please indicate your choice with an X. Individual / Legal Entity Details Surname First Names of Applicant / Business Name Applicant Identity Number / Business Registration Number Business Representative s Identity Number Physical Address of of Business Contact Number Individual / Fax Number Area Code Payment Method Cash Bank Transfer Other B. INFORMATION OF PROPOSED NEW OWNER T E A R H R Name Identity Number / Business of Date The above tracking number should be quoted in all future communication in respect of this application Keep this receipt as proof of Application submission C. CST / MANAGEMENT CHAT INFORMATION CST 1 CST 2 CST 3 CST 4 CST 5 MANAGEMENT CHAT CST Container Serial No* D. SITE INFORMATION SITE ADDRESS STREET SUBURB TOWN / TOWNSHIP REGION CONTAINER E* GENERAL CONDITIONS The ownership of the CST Product may only be transferred as a complete set and may not be broken down to individual items. The product does not include any Bank accounts or Bank Cards. I understand that I will have to sign a Contract that will govern the relationship between me and Cell C Pty Ltd. I also do understand that I will get approval from Cell C CST for any possible change in site address from where the CST phones will operate prior to such a move. I hereby declare that the information provided is correct and that I do understand and accept and agree to all the Community Service Telephone Terms and Conditions set by Cell C Pty Ltd. F* BANK REQUIREMENTS RECHARGE TEBA BANK APPLICATION FORM COMPLETED G* AUTHORITY TRANSFER LOCAL AUTHORITY AC POWER H. SIGNATURE SIGNED at on For. Applicant Signatory Capacity Authority Note If the Applicant is a Legal Entity signatory confirms Delegation of Authority. APPLICANT GENERAL INFORMATION Where indicated with an asterisk please indicate your choice with an X. Individual / Legal Entity Details Surname First Names of Applicant / Business Name Applicant Identity Number / Business Registration Number Business Representative s Identity Number Physical Address of of Business Contact Number Individual / Fax Number Area Code Payment Method Cash Bank Transfer Other B. Individual / Legal Entity Details Surname First Names of Applicant / Business Name Applicant Identity Number / Business Registration Number Business Representative s Identity Number Physical Address of of Business Contact Number Individual / Fax Number Area Code Payment Method Cash Bank Transfer Other B. INFORMATION OF PROPOSED NEW OWNER T E A R H R Name Identity Number / Business of Date The above tracking number should be quoted in all future communication in respect of this application Keep this receipt as proof of Application submission C. INFORMATION OF PROPOSED NEW OWNER T E A R H R Name Identity Number / Business of Date The above tracking number should be quoted in all future communication in respect of this application Keep this receipt as proof of Application submission C. CST / MANAGEMENT CHAT INFORMATION CST 1 CST 2 CST 3 CST 4 CST 5 MANAGEMENT CHAT CST Container Serial No* D.

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