hisher education

&"training
Depsrtflanti
Highar Eduffilioft and TEifii#g
REPUBLIc OF $OUTH AFNICA

APPLICATION FOR THE DEPARTMENT OF HTGHER EDUCATTON AND TRAINING (DHET) -

2OL7 FEE ADJUSTMENT GRANT

sEcTtoN 1

Government will subsidise the fee adjustment capped at8% on the 2015 fee for all qualifying registered students
with gross family income up to R600 000 per annum in 20t7. This is not a loan but a grant. The grant will reflect
as a credit on the student account once eligibility has been confirmed.

Closing date for applications isEhs follows: 10 February 2017

IMPORTANT INFORMATION - P/eose reod carefully

A. DEFINITIONS

Combined family income: Parents, spouses and/or legal guardians who earns an income to supporting the family
through wage, salary, grant, pension or other source of income including rental or business income;
Quintile: South African schools are divided into five categories (quintiles) based on the socio-economic status of
the community in which the school is situated. Quintile 1 schools are the poorest while quintile 5 schools are the
least poor.

B. ELIGIBILIry CRITERIA

Only South African citizens and citizens with a permanent South African residency studying towards an
undergraduate or postgraduate qualification in 2017 will be considered.
The applicant and direct family (mother, father, spouse or legal guardian) must have a GROSS combined family
income up to R600 000 per annum.
The DHET Grant will ONLY cover tuition fees and university managed accommodation (including operational leases
for student accommodation between the university and a service provider).
Applicants that applied for NSFAS funding are not required to submit this application, they will automatically
be considered.
All students who attended Quintile 1, 2 and 3 rchools in Grade 12 will be automatically considered upon
l. verification of HEMIS data and will not be required to submit this application.

COM PLETING THE APPLICATION

i. Please ensure that the application is completed i,r full. Certified copies of lDs of the parents/spouse and/or legal
guardians MUST be attached. lncomplete applications will not be considered.

l. Parents, spouses and legal guardians are requested to acknowledge that they understand that personal
information will be requested and provided to third parties who will assist the University with verifying income

l. and that their signature to the application constitutes express written consent.
Ensure that all parties (father/mother/spouse/legal guardian/student) complete and sign the relevantsections.

Appeals
r Sittdonic wha are unsuccessful in their application may appeal within 14 days of outcome of decision by
completing an Appeals Form which will be loaded on the University's website.
 gducation
it!ighel
tratntng
Dp*rtrnant:
Edffi8on and THtning
Hlgher
REPUBLIC OF SOUTH AFhfrCA

APPTICATION FOR THE DEPARTMENT OF HIGHER EDUCATION AND TRAIN|NG (DHET) -

2OL7 FEE ADJUSTMENT GRANT

sEcTtoN 2

Qualification (name in full

Other funding (bursaries,

scholarships): Please specify
sponsor, contact details of

Other fundine Yes V No

Name of sponsor Qc-eq
R (amount) RGg OCIo
2. Personal information of Parents/spouse/Legal Guardians where applicable:

Please complete the family details below. Parents/Spouse/Legal Guardians must sign consent giving the
University permission to verify employment information with a third party such as a credit bureau. The
information received will be used to verify employment, marital status and any other information material
to the financial information provided in this application.

Su rna me of Moth er/Spouse/Legal

Guardian

ldentitv number

Surname of Father/Spouse/Legal
Guardian NSsoLo

Total combined annual gross familv income

Student Full Names

studentsurname S\\SoL"
studentsisnr,rr",
@- ort" tf \Ot[?o\l
3. Declaration and Consent

(a) l/We am aware thereof that the Minister of Higher Education and Training has announced that
Government will pay the fee increases of students for 2017 (provide a non-repayable Fee lncrease
Grant) in cases where the combined income of a student's family is up to R 600 000 (six hundred
thousand Rand) (in other words, there will effectively be a 0% fee increase for those students in
2Ot7).
(b) l/We understand that, in orderforthe Universityto consider my/ourapplication forthe Fee lncrease
Grant, it will require certain personal information from me/us.
(c) l/We also understand that my/our personal information will be provided to third parties who will
assist the University with verifying my/our income and that my/our signature to this document
constitutes express written consent.
(d) l/We understand that there is no guarantee on the outcome of this application, as the criteria must
first be met and any incorrectfincomplete information may delay the outcome.
(e) I / We accept that any fraudulent information provided will automatically disqualify my application
and may result in a case of fraud being pursued against me or my parents/legal guardians/spouse.
(0 l/We have noted the following documentation and information that may be requested.

4. Documents to be submitted if required for the verification of income process:

a Certified copy of ldentity Document of yourself, your parents or legal guardians.

a lf either of your parents is deceased, a certified copy of the death certificate.
a Certified or official copy of recent payslip, letter of employment, not older than three months, for each
parent, or your guardian or yourself if you are employed.
Proof of income, bond statement and council rates accounts if parents/guardians are an informal
trader/hawker.
lf parents are employed by a company - salary/wage slips of both parents (not required in bullet 3
above.
a lRPs, lT3 and lT12 (last 2 years) if parents/guardians are earning commission.
a Signed and complete 2015 financial statements signed by members; lT14 - Tax return for the business
(last2years) |TLZ-Taxreturnfortheindividual (last 2years) andlT3(b) lncomeTaxCertificatefrom
the Bank (last 2 years) if parents/guardian/spouse own or are members of a CClftv (ltd) and /or sole
proprietor.
Official letter from the Department of Labour if parents/guardian/spouse are unemployed proving
unemployment status.
Copy of an official pension slip or bank statement if parent/guardian receives income such as
pension/grant/maintena nce/renta l/interest fro nr investment.

l/We also confirm that l/we have read and hereby accept the terms and conditions of this consent.

THUS signed and dated at T\SsSen q on this tffrry of .Ianar,.,'l 2016.

Mother/Spouse/Legal Guardian's signature_ ,/yb*

THUS signed and dated .t iiS"s tT on thrs SfOry of ScrrtqcrrJ 2016

Father/Spouse/Legal Guardian's signature: ft;

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RH: RETBET{GHryiHru3

Due i* operation*l requitei^fierit$ we her*by coilfirni that the above effiployee iras b*en retreflched by the
sorntrar'':y.

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Aneiine Erasmus
FHR AMffiIruNSTffiAY*R

Ii:Lenrf$rder Sif {Ft-v} Ltd

120 Doreer': Arrenue
Scssl',vn Exil , Pretcria
c12A
South Africa
Di.ectors: Carlr:s Deiich (Chaln.:eii); Olal Klirgl-ragert (Gerr;-ran'7): I Mr.zburgi iR'S.A.) Phone +27 1 2 521 75OC
Ielefax +2i 12 541 '1 B8a
 MAAutomaLive TcoL & Dle (ply) Ltd 'PERIoD END
Employee Namer IrI}EOX0 W S&TE; 2aL6ltLlL3
EnrpNo:872?
PAYPOINTT PlanL,1 DEPARTI{EMI: F30 BL{W
PAY IIIETHOD: ACB
BRANCH:470010 ACCOUNT NQ; 131"0282593
TAX REF tiO, f::lO:OtSa IDEMITY N0r 70061?0374086
AIDRESS: 1188 PHASE l
DATE ENGAGED : 20t3 / 08 /26
*T0B TITLE: operatof
MED AID ADULT DEP: 0.00 IlmD A.ID CHILD DEP: 00 I
RETIREMENT 0PT10N: ASt BAI"frUCEE
PAY R.A,TE: 50.6300

EARNINES HOURS/UNI?S DEDUCTIOSS $OURS/UNITS AMOE$Y BArA0icEs

Night Shift 40.00 20?5.t0 1dt 194.88

N/shrtL 0/T l-.5
N/shift &}lovan
4.ofl 303. ?8 u.r.r., : 32.,?4
.Peneion FuRd L41.76
Medical Aid: r.45 .63
Spouse Inguranc t}96
MIBCo tBvy 2.65
NUlrsA 2A.25
NUI4SA Condolenc 2A.AA

ffi
=;:;;r;Gffiil*6u'[ui 11:lsffiffi ffi$''ffi

1lfrifih'ffit:W'
1s:M
ffi
TOTAL EARNINES 2885.91 TOTAI DEDUCTIONS s69. B?

ToLal Perks 356. 2s TfET SAIARY 23t6.04

Total Company Conlributions 840.55

Year co^date Totals

Taxable Earnings 97171.90

9vt2.sI
Additional Tax 0.00
ToLal Perks 121 44.36
Annual teave due ut. r5Jb
YTD Shifts 0. 00
 l{A AuLomative Tool & Die {Btyl trd
Employee Name: NtsoKo M,l PERI0! E$! DAT!: 21t6lll/r0
PAYPOINT: planL EmpNo:872?
1
DEPARTMENT: F3O BMtr{
PAY METHOD; ACB
8t*IfCI{:4?001.0 _ ' ACC0IINT NR : 1310282593
TAX REF N0: 1332030152
IIEXIEIfY S0 r ?S061?03?4{86
ADDRESS: 1188 PHASE 1 daB TITLET 0perator
DArE E$0ASED | 2013 / o8I 26
MED AID ADULT DEF: 0.00 . l
I{ED AIfi CIIILfi DEP r 00
RETIREIVIENT OPTION: AG1 EAtA$&n {.*
FAt ,*AtE; 50. 1300

EARNIIJGS.

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z4 {-\ .-/' <s(-
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fr$Z-^ see"

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t\rt \\wi/jc
-*eo};s( ?v--,

TOTAL EARN]NGS
222't .'12 fOIEI .DEDUCTIOI{S
.
424.s2
Tota.l perks
355,.r5 I{ET SAIARY
Toral Company ConLriburions s24 .99
1802,90

Year-to-date TotalB

Taxa&le Earnings
9943,A,02
?as
564i31
Additional Tax
0,00
Total perke
13100.61
Annual l,eave due
.84,4613
y?D Shifts ' O:00
M& Automative Tool e Die {pty} Ltd FEEIOD HI{D nATEr 2a:' 6/fi127
EmpNo:872?
FAYFOlt{TrF}anLI ,
DEPARTI-{ENTr, F30 BW{'
PAY METHOD: ACB BMNCH: 47001"0 A{C0UNT Ii&r 1310282593
TAx REF N0: 1332030152 IilSNTITY I{0: ?0061703?a0S6 DAtE. ENGA$SD: 20fi I Afil26
AIDRESS: 1188 PHASE r JoB TITLE: 0perator
MED AID ADULT DEP: 0.00 MED AID Ci{il,I} DEP: ' 00 " *,
RETIREMET| 0?TI0N: 461:EAI,ASCED PAY RATE: 54.9300

EATN]gGg HAI]8.$/U}TITS AMoglff DEDUCTIO$S HouRsluNrTs Ar40ul{T BAIANCSS

Fioxnirg Shifl 40. 00 2L97 .24 493 .04

Ml SnIIt AIlo\r/an 109. 86 u.1. tr. 49.57
Backpay 456 ,00 1969. 80 Pension Fruld L53, $0
Bachpay overlim 8.00 51.60 Madical Aid 145.63
Backpay Allorr,ran n2.24 Spouse fnactranc L2.9'-7
MIBCO Ire?T' 2.55
NUI\4SA. ] 2L.7'.]

ffiu*
W
f**u*t' t ..n- \
'u
l$t -"*--.<

rOTA], EARNISGS 455_1 . bb TOTAT DEEflCTICNS e"/9.67

'I',OCar gerKs 374.L4 NET SATARY 367L.99

Tota1 qompany ContribuLions , 927.71
.:
Year-t0-date Tslals
qi

Taxablq Earniags, 104018,. S4

."
Tax 61.44.35
AddiLional Tar c.00
total Perks :13474.75
:I,eave
Annual 4ue B6:.7690
" 4"00
 NlA Automative Tool & Die (pty) Ltd FERI0I EM DATEI z0L6/Lz/04
Employee Name; IflS01t0 M,l EmpNo: 872?
PAYPOINT: PlanL I DEPARIIEI{T: F30 B}.{i{'
PAY METI]OD; ACB DDntrInu. 1/uutu
urwrvrr. ,rn hl n ACCOUNT NRr 1310282593
TAX REFN0: 133203015? IDENTITY N0: 70061?0374086 DATE ffiIGACEDr ?013/08/?6
ADDRESS: 1LB8 pHASE 1 ilUE'1'l-'.t'!E: UperaEor
MED AID A-DULT DEP: 0.00 MED AID CHIID DEP: OO
RETIREMENT OPTI0I{: AGL BALA$CED PAYTRATE: 54,9300

EMN]NGS HOURS/UNITS }MOUNI DEIUCTIONS HOURS/UNITS AMOUBT BAI,ANCES

Normal Pay ]O Pfi

2L69.74 66,42
U.'I. F, el, vl.
Pensioo Fuud 153.80
Medi.catrAld 145.63
$pouse l]Isuran* 12.97
WBC0 leyy " z, 05
$UTISA . 11 0'

TOTAI EARN]NGS alra 1A

TOTAT DEDI}CTIOI{S 429.35

ToLal Perks 3?4. t 4 NET SAI,ARY r740.39

Tota} Company Contributions 888. 09

Year-to-date ToEaIs

Taxable Earnings 106235 .54

Tax 620s,71
Additional Tax * 0.00
Total Perks u848. 89
Arurual Leave due 89,0?6?
YfD Shifts