Fillable Form 1.: AANSOEK OM AANSTELLING AS KOMMlSSARlS VAN (South Africa Department of Justice and Constitutional Development)

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Form 1.: AANSOEK OM AANSTELLING AS KOMMlSSARlS VAN (South Africa Department of Justice and Constitutional Development)

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AANSOEK OM AANSTELLING AS KOMMlSSARlS VAN EDE
APPLICATION FOR APPOINTMENT AS COMMISSIONER OF OATHS
(Moet in tik- of drukskrif ingevul word en persoonlik deur die applikant by sy plaaslike landdros, met wie vooraf
vir 'n onderhoud gereel is, ingehandig
wordno be completed in typing or block letters and handed to the
applicant's local magistrate personally after arrangements have been made for an interview.)
1.
(i) Volle naam (Mnr./Mev./Mej.)
Full names (MrIMrslMiss)
........................................................................................................................
(ii) ldentiteitsnommer
Identity number
........................................................................................................................................
2.
~Geboortedatum
3.
Beroep
'Date of birth
.................................................
Occupation
............................................................................
4.
:Opvoedkundige kwalifikasies
.................................................................................................................................
Educational qualifications
(a)
Woning/Residence
(b)
Besigheid/Business
Distrik Distrik
District
..................................................
....................
District
.......................................................................
(c) Posadres
Postal address
............................................................................................................................................
6.
Telefoonnommers: Woning Kode
Telephone. numbers:
Residence
..........................................................................
Code
............................
Besig heid Kode
Business
............................................................................
Code
.............................
REPUBLIC OF SOUTH AFRICA
Department of Justice and Constitutional Development
7.
Taalbedrewenheid vir doeleindes van behoorlike uitvoering van pligte as kommissaris van ede. (Vermoe
orrl te praat, lees en skryf.)
La~nguage proficiency for purposes of proper performance of duties as commissioner of oaths. (Ability to
read, write and speak.)
9.
Distrik(te) of gebied waarvoor aanstelling verlang word
District(s) or area for which appointm,ent is required
........................................................................................
Noern taal
State
language
(i)
(i
i)
.............
;.
(ii~i)
(iv)
(v)
...................................
(vi)
(vii)
(viii)
...................................................
(ix)
(x)
(xi)
....................................................
--
10.
Naam van firmalwerkgewer
Narne of firmlemployer
.....................................................................................................................................
11.
Aard van besigheid
Nature of business
............................................................................................................................................
8.
Is
LI
ooit skuldig bevind aan strafregtelike oortredings? lndien wel, verskaf volle besonderhede:
Have you ever been convicted of criminal offences? If so, state full particulars:
12.
Hoedanigheid waarin aanstelling werlang word (byvoorbeeld Bestuurder van ABC Maatskappy):
Capacity in which appointment is required
(e.g. Manager of ABC Company):
Praat
Speak
.;
Lees
Read
:-
:
Skryf
Write
Skryf
Write
.....................................................................................................................................................
.....................................................................................................................................................
.....................................................................................................................................................
.....................................................................................................................................................
.....................................................................................................................................................
Praat
Speak
.......................................................................................................................................................................................
......................................................................................................................................................................................
................................................................................................................
Praat
Speak
Lees
Read
.......................................................................................................................................................................
.................................................................................................
................................................................................................
Lees
Read
Skryf
Write
Department of Justice and Constitutional Development
MARK with an "X"
13.
Aantal werknemers in diens van firma by applikant se besigheidsadres
.......................................................................
Number of employees in employ of firm at applicant's address
14.
Totale aantal werknemers van firma
..............................................................................................................................
Total number of employees
15.
Benaderde aantal persone vir wie die kommissaris van ede se dienste beskikbaar sal wees
.........................................................
Approximate number of persons who will be served by the appointment
16.
Dokurnente wat na verwagting geattesteer sal word:
Documents applicant will be required to attest:
Aantal per maand
Number per month
17.
Sal u 'n eed of bevestiging afneem met betrekking tot sake waarin u 'n belang het ingevolge die
Will you administer an oath or affirmation relating to matters in which you have an interest in terms of the
bepalings van regulasie 7 van die Regulasies wat ingevolge
artikel 10 van die Wet op Vrederegters en
provisions of regulation 7 of the Regulations published by Government Notice R. 1258 of 21 July 1972 and
Kommissarisse van Ede, 1963 (Wet 16 van
1963), afgekondig is by Goewermentskennisgewing
R.
1258
promulgated in terms of the provisions of section 10 of the Justices of the Peace and Commissioners of
van 21 Julie
1972?
JaINee.
Oaths Act, 1963 (Act 16 of 1963)?
YesINo.
18.
Afstand na naaste kommissaris van ede of vrederegter vanaf:
Distance to nearest commissioner of oaths or justice of the peace from:
Woning Besigheid
......................................................................
................................................................
Residence Business
Department of Justice and Constitutional Development
19.
Dui volledig aan waarom u van oordeel is dat u aanstelling noodsaaklik in die
openbare belang
is ten spyte
van die groot aantal persone wat ampshalwe aanstellings as kommissarisse van ede hou. (Gebruik 'n
bylae indien
nodig.)
Indicate fully why you are of the opinion that your appointment is necessary in the
public interest
in spite
of the large number of persons who hold
ex oficio
appointments as commissioner of oaths. (Use an
annexure if necessary.)
20.
(a) Hou enige van die werkgewers, werknemers, vennote, direkteure, ensovoorts, verbonde aan die
firma 'n aanstelling as kommissaris van ede? lndien wel, verskaf volle name, hoedanigheid waarin
aangestel en datum van aanstelling:
Do any of the employers, employees, partners, directors, etc., connected with the firm hold an
appointment as commissioner of oaths?
If so, state full names, capacity in which appointed and date
of appointment:
(b) lndien paragraaf 20 (a) hierbo bevestigend beantwoord is, dui volledig aan waarom die aanstelling
van 'n bykomende
persoon as kommissaris van ede noodsaaklik is. (Gebruik 'n bylae indien nodig.)
If paragraph 20 (a) above was answered in ttie affirmative, motivate fully why the appointment of an
additional person as commissioner of oaths is essential. (Use an annexure if necessary.)
Department of Justice and Constitutional Development
21.
Is u en/of enige van die persone in voormelde paragraaf 20 (a) genoem lid van 'n statutGre liggaam, raad,
kommissie, komitee, plaaslike bestuur of plaaslike owerheid wat
ingestel is ingevolge enige wet of
ordonnansie? lndien wel, meld besonderhede:
Are you
andlor any of the persons mentioned in the foregoing paragraph 20 (a) a member of a statutory
body, board, council, committee, commission or local authority established under any act or ordinance?
If so, state particulars:
22.
Ander inligting
Other information
..............................................................................................................................................
Datum
Date
....................................................................
(*
Waar van toepassingMlhere applicable.)
Datum
Date
......................................................................
(Slegs vir amptelike gebruiWFor official purposes only)
Verwysingsnommer:
Reference No.:
Landdroskantoor:
Magistrate's Office:
1/9/4
Hoofkantoor:
Head Office:
911
1812..
..............................
23.
Is die applikant geskik vir aanstelling?
Is the applicant suitable for appointment?
Department of Justice and Constitutional Development
24. Is (lie aanstelling noodsaaklik in die openbare belang in die lig van die groot aantal persone aangewys
ingevolge artikel 6 van die Wet op Vrederegters en Kommissarisse van Ede, 1963 (Wet 16 van 1963)?
(Motiveer volledig.)
Is the appointment necessary in the public interest in the light of the large number of persons designated in
terrns of section 6 of the Justices of the Peace and Commissioners of the Oaths Act, 1963 (Act 16 of
1963)? (Motivate fully.)
Datum
Date
....................................................................
..............................................................................
Landdros/Magistra te
Datum
Date
....................................................................
Department of Justice and Constitutional Development
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Form 1.: AANSOEK OM AANSTELLING AS KOMMlSSARlS VAN (South Africa Department of Justice and Constitutional Development)

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Completed 29 March 2022

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