DEPARTMENT OF JUSTICE AND CONSTITUTIONAL DEVELOPMENT
J251A
REPUBLIC OF SOUTH AFRICA
FOREIGN APPLICATION FOR MONIES FROM GUARDIANS FUND
Inheritance
Insolvent
Creditors
Expropriation
Termination of Usufruct
(Please mark appropriate box above with X)
A. PARTICULARS OF APPLICANT
Full Names & Surname
Identity Number
Type of Marriage
Date of Marriage:
Full Names of Spouse:
Full Names of Both Parents:
Postal Address:
Tel/Cell Number:
B. PARTICULARS OF ESTATE
Name of Estate / Company
in Liquidation (if applicable):
Estate Reference Number:
(if applicable)
GF File Number: (if available)
C. NOTE:
AGENTS:
ALL SERVICES RENDERED BY THE GUARDIAN’S FUND ARE FREE OF CHARGE.
THE GUARDIAN’S FUND IS IN NO WAY LINKED TO THE SERVICES OF AGENTS.
IN TERMS OF SECTION 51(1) (f) OF THE CONSUMER PROTECTION ACT, 2008 (ACT NO. 68 OF 2008): A SUPPLIER
MUST NOT MAKE A TRANSACTION OR AGREEMENT SUBJECT TO ANY TERM OR CONDITION IF - IT PURPORTS TO
CEDE TO ANY PERSON, CHARGE, SET OFF AGAINST A DEBT, OR ALIENATE IN ANY MANNER, A RIGHT OF THE
CONSUMER TO ANY CLAIM AGAINST THE GUARDIAN’S FUND
1. I have been assisted by an AGENT. YES NO
2. Name and Surname of Person assisting me: …………………………………………… Contact No: …………………………...
3. I am aware of the contents of Section 51(1) (f) of the Consumer Protection Act, as referred to and I do not need to make any
payments in respect of fees to an AGENT. YES NO
4. I still request the Master to proceed with the payment into my bank account as per my banking details below regardless of the
warning in respect of AGENTS. YES NO
** 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.
J251A
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:___________________________
Date Stamp of Bank
Signature of Bank Official:________________________
E. DECLARATION
I,.………………………………………………………………………………………………….….. the undersigned, declare under oath /
affirm and say that I am entitled to the funds claimed herein and that the particulars stated in this application are true and correct to
the best of my knowledge and belief. I also undertake to inform the Department of Justice & Constitutional Development should any
of the above details change in any way.
……………………………………………… ……………………………………………………………………..
DATE PRINT NAME AND SURNAME
……………………………………………………………………..
I certify: SIGNATURE OF APPLICANT
1. that I have satisfied myself as to the identity of the applicant;
2. that the deponent has acknowledged that he / she knows and understands the contents of the affidavit which was signed
before me;
3. That the affidavit was sworn to / affirmed before me at ……………………………………………………………………………….
on this …………………………..….. day of ……………………………………….… 20 …………………..
…………………………………………………………………………………..
Notary Public/Official of the Embassy/Office of the High Commission
Full names: ………………………………………………………………….
Area for which appointed: …………………………………………………
Officio ex officio: ……………………………………………………………..
Address: ……………………………………………………..………………..
FOR
OFFICE
USE
ONLY
APPLICATION
APPROVED / NOT APPROVED
COMMENTS
PRINT NAME AND SURNAME
DATE
SIGNATURE
STAMP
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