Department of Justice and Constitutional Development
21
FORM 5
[Regulation 7]
NOTICE TO RESPONDENT TO SHOW CAUSE (SUBMIT REASONS)
WHY A PROTECTION ORDER SHOULD NOT BE ISSUED
SECTION 5(4) OF THE DOMESTIC VIOLENCE ACT, 1998 (ACT NO. 116 OF 1998)
IN THE MAGISTRATE’S COURT FOR THE DISTRICT OF ____________________
HELD AT ___________________ APPLICATION NO._______/_____
In the matter between:
APPLICANT: ______________________________________________________
(*Id.No./Date of Birth:_________________________________)
AND
RESPONDENT: ____________________________________________________
(*Id.No./Date of Birth:_________________________________)
NOTICE TO RESPONDENT:
1. Particulars of Respondent:
Home Address: ______________________________________________
______________________________________________
______________________(Tel.No._______________)
Work Address: ______________________________________________
______________________________________________
________________________(Tel.No._______________).
2. Particulars of Application
On ................................ (date), the Applicant applied for a protection order against
you. The Court considered the application but has not issued an interim protection
order but will on the undermentioned date decide whether or not to issue a
protection order against you.
3. Protection Order
3.1. You are hereby called upon to give reasons why a protection order should not
be issued against you by the above-mentioned Court on the .........................
day of ............................................. at 08:30, on the basis of the application
and supporting affidavits, if any, of which certified copies are attached hereto.
REPUBLIC OF SOUTH AFRICA
