Social Assistance Act, 2004 (Act No. 13 of 2004)

Regulations

Regulations relating to the Lodging and Consideration of Applications for Reconsideration of Social Assistance Application by the Agency and Social Assistance Appeals by the Independent Tribunal

Annexure A : Consolidated Forms

Form 5 : Summon to Appear Before the Independent Tribunal
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FORM 5

 

SUMMON TO APPEAR BEFORE THE INDEPENDENT TRIBUNAL

(Regulation 18(2))

[Section 18(1A) of the Social A881atance Act 13 of 2004]

 

A.        PERSONAL DETAILS OF APPLICANT OR BENEFICIARY

Surname:

Full Names:

ID Number:

Nationality:

Gender:       M

F

Tel No:

Fax No:

Email:

Cell No:

Physical Address

Postal Address

 

 

You are hereby summoned to appear before the Independent Tribunal on ................................

(Date) ..............................(Time) at.............................................................................................

........................................................................ (Venue).

 

The purpose of your appearance is to notify you of the medical examination which you have to undergo prior finalisation of your appeal which you lodged on ................................................................

 

 

 

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

 

 

(ITSAA official)

 

 

ITSAA date stamp: