50

Government Gazette 17 May 2001

No. 2532

Surname: ..................................................First Name:......................................

Citizenship: ..............................................Id.: ..................................................

Date of birth: ............................................Sex:. ................................................

Office and traditional title (if any)......................................................................

7. 	 Give the reason for the proposed designation:............................................

8. 	 Give a summary of the customary law applicable in the Traditional
Community in respect of the designation of a *Chief/Head of the
Traditional Community:
....................................................................................................................

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

I.............................................................................................. declare that the
above information is, to the best of my knowledge and belief, correct.

Signed this day ....................of .............................at.....................................


..........................................................
Signature of applicant
*Delete whichever is not applicable.

page 50

..................................................
Title of applicant

Select target paragraph3