Gas Act, 2001 (Act No. 48 of 2001)

Rules in terms of the Gas Act, 2001

Annexures

Annexure H : Form: Complaint (Optional)

Section D: Solemn Declaration by the Complainant/Mandated Representative
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I (full names) ..........................................................................................Identity Number ...................................................hereby declare that:

(a)I am authorised by ............................................................................................................................to make this declaration (attach the authorisation) if applicable; and
(b)All information provided herein is within my personal knowledge and is both true and correct.

 

 

........................................................................................

Signature

 

 

I certify that the deponent:

(a)has acknowledged that she/he knows and understands the contents of this application form and its annexures, that she/he has no objection to taking the prescribed oath and that she/he considers the oath binding on her/his conscience; and
(b)has in the prescribed manner sworn that the contents of this application form and its annexures are true and signed same before me at ..............................................................(place) on this.....................day of...................................(month) ...............................(year).

 

 

____________________________________________________

COMMISSIONER OF OATHS

 

Name          ______________________________________________________________________

 

Address      ______________________________________________________________________

 

Capacity     ______________________________________________________________________