FORM 45: Notice of Intention to Register as an Excluded Person

[]
1 Step 1
FORM 45: Notice of Intention to Register as an Excluded Person
1. I (Name of Applicant):

in terms of the provisions of the Act and these Regulations, do hereby notice my intention to be registered as an excluded person.

2. Physical address
0 /
Postal address
0 /
Telephone
Fax
Tax No.
3. State the reason(s) for the application:
0 /

DOCUMENTS TO BE SUBMITTED WITH THIS APPLICATION

1. Two identical and recent coloured passport-size photos of person to be excluded;
Upload
2. Certified copy of identity document (Omang or passport).
Upload
I certify that the information supplied on this application form (please print name clearly) is true and correct. I understand that failure to provide true and correct information will result in the failure of this application.
Previous
Next