Films and Publications Act, 1996 (Act No. 65 of 1996)RegulationsFilms and Publications Regulations (Games), 1999AnnexuresAnnexure 3 : Prescribed form for application for exemption |
Annexure 3 : Regulation 4(a)
FPB 18/EC: Section 22 AND 23 of the Films and Publications Act, 1996
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FILM AND PUBLICATION BOARD 13th Floor Pleinpark Building Private Bag X9069 Cape Town 8000 Tel (021) 465 6518 Fax (021) 465 6511 |
The Board may refuse to process your application if this form is not completed fully |
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(For Office Use) Ref. No. Date Received: APPLICATION FOR EXEMPTION, dated ....................................................................................... Applicant .................................................................................................................................. Address ..................................................................................................................................... Tel.......................................Fax.................................E-mail...................................................... Contact Person.......................................................................................................................... Title and Version of Game ......................................................................................................... Year of Production .................................Country of Origin ........................................................ Name of Publisher .................................................................................................................... Proof of right to distribute the game in the Republic ................................................................. ................................................................................................................................................. Description of Game Play ......................................................................................................... ................................................................................................................................................. ................................................................................................................................................. ................................................................................................................................................. ................................................................................................................................................. Reasons or Grounds for Exemption............................................................................................ ................................................................................................................................................. ................................................................................................................................................. ................................................................................................................................................. If the game does not contain contentious material, please complete the following statement:
I, ........................................................................................................................the undersigned, hereby state that the game forming the subject of this application does not contain any contentious material and is suitable for play by a child without parental guidance or supervision. A copy of the advertisement intended to be used to advertise and promote this game is attached hereto.
Signed: ......................................................................................................................................
Capacity if on behalf of a firm .................................................................................................... |
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