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STAATSKOERANT, 9 MAART 2001
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No. 22125 15
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C.
111
Particulars of person on whose behalf request is made
r
This section must be completedonly y a requestfor informution is made on beharfof
another person.
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Full names and surname:
number:
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Identity
D.
(a)
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Particulars of record
Provide full particulars of the record to which access
reference numbervthat is known to you, to enable the record to be located
(b)
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I f the provided space is inadequateplease co,ntinueon a separatefolio and attach
it to t h i s j b m The requester must sign all &headditionalfolios.
1.
Descriptionofrecord or relevant part of the record:
2.
Reference number, if available:
3.
Any further particulars of record:
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1
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