Regulations > Immigration Regulations, 2014 > Annexures > Annexure A: Forms

(DHA-1567) Form 40

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LIST OF STOWAWAYS

[Section 7(1)(g) read with section 35(5)(b); Regulation 33(10)]

The person in charge of a conveyance entering a port of entry in the Republic shall, on demand, deliver to the immigration officer a list of stowaways.

PART A

STOWAWAYS

Details of Conveyance

Name of conveyance: .....................................................................................................................................................................................

Registration No: .............................................................................................................................................................................................

Name(s) and surname of person in charge of conveyance: ..............................................................................................................................

Port of entry: .................................................................................................................................................................................................

Date of entry: ................................................................................................................................................................................................

PERSONAL PARTICULARS OF STOWAWAYS

Surname	First name(s)	Passport/Travel document No	Type of travel document	Nationality

PART B

DETAILS OF STOWAWAY

(To be completed in respect of each stowaway)

PERSONAL PARTICULARS OF STOWAWAYS		Photograph of stowaway
Names(s): .....................................................................................................................................
Surname: ......................................................................................................................................
Date of birth: ................................................................ Place of birth ...........................................

Nationality....................................................................... Country of origin ...........................................................................................................................

First language: .................................................................. Other spoken languages: ...............................................................................................................

Passport/travel document No.: ......................................... Date of issue .................................................................................................................................

Place of issue: ................................................................... Date of expiry: ..............................................................................................................................

Issuing authority: ...................................................................................................................................................................................................................................................................

Home address/Address in country of boarding .......................................................................................................................................................................................................................

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

Employer's name: ..................................................................................................................................................................................................................................................................

Employer's address: ...............................................................................................................................................................................................................................................................

Height: ..................................................... Weight: ..................................................... Marital status: .............................................................................................................................

Name(s) and surname of spouse: ...........................................................................................................................................................................................................................................

Nationality of spouse: ................................................................................................. Address of spouse: .......................................................................................................................

Names and surname of parents: .............................................................................................................................................................................................................................................

Nationality of parents: ...........................................................................................................................................................................................................................................................

Address of parents: ................................................................................................................................................................................................................................................................

STOWAWAY DETAILS

Date found: ......................../........................./............................ Time found: ....................................................................................................................................................

Place of boarding .................................................................................... Country of boarding ........................................................................................................................................

Time spent in country of boarding: ..................................................... Intended port of destination: .........................................................................................................................

Intended final destination (if different): ..............................................................................................................................................................................................................................

Stated reasons for boarding the ship ....................................................................................................................................................................................................................................

OTHER DETAILS

Method of boarding, including other persons involved (e.g. crew, port workers etc.), and whether they were secreted in cargo/container or hidden in the vessel:

Inventory of stowaway's possessions:

Was the stowaway assisted in boarding the vessel, or assisted by any member of the crew?

If so, was any payment made for the assistance? .................................................................................................................................................................................................................

Statement made by the stowaway (attach additional page, if space is not enough):

Statement made by the person in charge of the conveyance (Master), including any observations on the credibility of the information provided by the stowaway:

I hereby certify that this list contains the particulars of all stowaways found on board my conveyance.

Date of interview of the stowaway: ............................................................ Place: ........................................................................

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

Signature of stowaway Place Date

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

Person in charge of conveyance Place Date

ACKNOWLEDGEMENT OF RECEIPT

I, ...............................................................................................................................................................(name of immigration officer) hereby confirm receipt of the list of stowaways in terms of section 35(5)(b) of the Act.

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

Signature of immigration officer Place Date

Immigration Act, 2002 (Act No. 13 of 2002)

Regulations

Immigration Regulations, 2014

Annexures

Annexure A: Forms

Form 40 (DHA-1567)