Disaster Management Act, 2002 (Act No. 57 of 2002)

Regulations

Regulations issued in terms of Section 27(2) of the Disaster Management Act, 2002 (COVID-19)

Annexures

Annexure A : Forms

Form 4 : Permit to Travel to and from Gauteng other for a Funeral
Purchase cart Previous page Return to chapter overview Next page

 

FORM 4

PERMIT TO TRAVEL TO AND FROM GAUTENG OTHER FOR A FUNERAL

 

(To be completed by the head of court or a station commander or a person designated by him or her respectively.)

 

I,______________________________________ (full names of *head of court, or a person designated by him or her/station commander of a police station or a person designated by him or her) for—

(a) the Magistrate's court for the district of ____________________;
(b) the police station at _____________________________________,

 

hereby issue this permit for travel to another district/province, to the following person:

 

Full names

Surname


Identity number

Address of place of residence:

Province of residence:

Contact details

Cell nr.

Tel No (h)

Email Address



Province traveling to:

Date of funeral:

 

I also declare that the above-mentioned person presented the *death certificate/certified copy of the death certificate/affidavit to me.

 

Signed at ___________ this _____________ day of____________________20____

 

_____________________________


Official stamp

* Person issuing permit














 

[Form 4 substituted by section 6 of Notice No. R. 565, GG44772, dated 27 June 2021]