Protection from Harassment Act, 2011 (Act No. 17 of 2011)NoticesNational Instruction 1/2013 : Protection from HarassmentFormsSAPS 590(c) : Application by Station Commander for Extension of Time or Cancellation of Direction |
SAPS 590(c)
SOUTH AFRICAN POLICE STATION
APPLICATION BY STATION COMMANDER FOR EXTENSION OF TIME OR CANCELLATION OF DIRECTION
Section 5(3)(b) of the Protection from Harassment Act , 2011 (Act No 17 of 2011)
If this application is filed by delivering it to the clerk of the court personally, it must be completed and submitted in duplicate.
DIRECTION NO: ....................................................................../ 20...................
AFFIDAVIT NO: ...................................................................../20...................... APPLICATION NO: ......................../..........................
To: .................................................................................................................................................................................................................(The clerk of the court)
Fax number: ....................................................................................................
From: ............................................................................................................................................................................................................(*station commander I *designated member of ..............................................................................................................police station)
Fax number: ..................................................................................................... E-mail address of station commander : ..................................................................
Phone number of station commander : ........................................................................................
TO BE COMPLETED BY THE STATION COMMANDER :
I hereby apply for —
*an extension of the time within which the affidavit must be submitted to court, in terms of section 5(3)(a) of the Protection from harassment Act; or |
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*the cancellation of the direction on the grounds that, after a reasonable investigation of the matter, the South African Police Service is not in a position to determine the name and address of the respondent or obtain any other information in order to identify or trace the respondent. |
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Indicate with "X" in the appropriate column
I, Persal number ........................................................... Rank ........................................ Name and Surname ............ ..............................................................the station commander of the .......................................................................... police station, in support of this application hereby state under oath as follows:
................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
The above statement was made by me at the place, date and time as indicated
*I know and understand the contents of this statement.
I have no objection to taking the prescribed oath.
I consider the prescribed oath to be binding on my conscience.
OR
*I truly affirm that the content of this statement is true.
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SIGNATURE OF DEPONENT
I certify that the deponent has acknowledged that he/she' knows and understands the contents of this statement which was sworn to/affirmed' before me and the deponent's signature was placed thereon in my presence.
Signed and sworn to / solemnly confirmed' in my presence on this ....................... day of ......................................20............. at .......................................(place) at ......................... (time).
.................................................................
COMMISSIONER OF OATHS
Full names and surname: ..................................................................................................................
Designation: .......................................................................................................................................
Area for which appointed: ..................................................................................................................
Business address : ..............................................................................................................................
TO BE COMPLETED BY THE CLERK OF THE COURT ON RECEIPT OF THE AFFIDAVIT FILED IN TERMS OF REGULATION 15(2)(a) OF THE
PROTECTION FROM HARASSMENT REGULATIONS:
I, ............................................................................................................................................................................(name and surname of the clerk of the court), hereby certify that I have received the affidavit from .........................................................................................................................................................(name and surname of person who furnished affidavit to clerk of the court) on ...................................................................(date).
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CLERK OF THE COURT