DEPARTMENT OF JUSTICE AND CONSTITUTIONAL DEVELOPMENT
J341A
REPUBLIC OF SOUTH AFRICA
APPLICATION FOR ALLOWANCE OR INTEREST
ALLOWANCE
INCAPABLE
PERSONS
USUFRUCT
INTEREST
FC INTEREST
(Please mark appropriate box above with X)
A. PARTICULARS OF APPLICANT
Full Names & Surname:
ID Number:
Residential Address:
Postal Address:
Tel Number (Work):
Tel Number Home):
Fax Number:
Cell Number:
E-Mail Address:
I, ………………………………………………………………………………………………………………….
hereby apply for the following : (Please mark appropriate box below with X)
ALLOWANCE
SCHOOL
FEES
HOSTEL FEES
TRAVEL FEES
CLOTHING
STATIONERY
SCHOOL
UNIFORM
OTHER;
SPECIFY
Supporting documentation must be attached to this application (e.g. quotes, accounts etc.)
I confirm that the under mentioned minor(s) is/are under my care and responsibility and that I am not financially able to
maintain and educate the minor without the financial assistance now requested.
NB: IN TERMS OF SECTION 90 OF THE ADMINISTRATION OF ESTATES ACT 1965, (ACT 66/1965) THE
MASTER HAS THE RIGHT/DISCRETION TO DETERMINE THE AMOUNT PAID. YOUR APPLICATION MAY
THEREFORE BE APPROVED/DECLINED/REDUCED.
B. FULL PARTICULARS OF MINOR(S):
1.
Full names & Surname:
ID number:
2.
Full names & Surname
ID number:
3.
Full names & Surname
ID number:
4.
Full names & Surname
ID number:
C. PARTICULARS OF ESTATE
Name of Estate:
Estate Reference Number: (if applicable)
GF File Number:
(if available)
** NB: ALL DETAILS REQUESTED ON THIS FORM MUST BE COMPLETED IN FULL. YOUR OMISSION WILL
RESULT IN YOUR INCOMPLETE FORM BEING RETURNED TO YOU.
***THIS APPLICATION MUST BE PRINTED ON ONE PAGE ONLY (FRONT AND BACK). TWO PAGE
APPLICATIONS WILL NOT BE ACCEPTED.
J341A
DEPARTMENT OF JUSTICE AND CONSTITUTIONAL DEVELOPMENT
2
D. BANK DETAILS OF THE APPLICANT
The Director General : Department of Justice and Constitutional Development
I hereby request and authorise you to pay any amounts in respect of Guardians Fund which may accrue to me to the credit of my / our account with
the authorised financial services provider mentioned below.
I understand that the credit transfers hereby authorised will be processed electronically to the account specified below. I also understand that any
banking costs for transactions (withdrawals/bank statements/etc.) made on the account will be borne by me. The Department of Justice &
Constitutional Development will not be liable for any banking costs on the account. I also hereby indemnify the Department of Justice &
Constitutional Development for any incorrect detail and information that may have been specified on this form.
Name and
Physical
Address of
Bank:
Name of Branch:
SWIFT/ Sort:
IBAN:
Name of
Account Holder:
Branch Code:
Account
Number:
Type of Account:
Current Account
Savings Account
Name of Bank Official: ……………………………………………………………………..
Signature of Bank Official:………………………………………………………………..
E. CERTIFICATE OF MAINTENANCE
I, …………………………………………………………………… the undersigned, certify that the aforementioned minor(s)
has/have been properly maintained by the applicant during the period from ………………………………………………. to
…………………………………………………………………………. and recommend that the allowance/maintenance
applied for be granted to the applicant.
NAME: …………………………………………………………………. SIGNATURE: …………………………………..
CAPACITY: ……………………………………………………………. Responsible person (i.e. Maintenance Officer/school
teacher/Minister of Religion/Social Worker/Tribal
Authorities or other responsible person)
DATE: …………………………………………………………………..
PLACE: ………………………………………………………………..
Stamp of Institution
I ……………………………………………………………………………………………the undersigned hereby confirm that all
the above mentioned information stated above is true and correct.
Signed at……………………………….…………………..on this…………….day of………………………………..20…….…….
Signature of Applicant: ………………………………….. Relationship to Minor: …………………………………………..
Signature of minor: (10 years or older) ………………………………………………..
FOR
OFFICE
USE
ONLY
APPLICATION
APPROVED / NOT APPROVED
COMMENTS
PRINT NAME AND SURNAME
DATE
SIGNATURE
Date stamp
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