No. 2532
Government Gazette 17 May 2001
51
PART B
THE FOLLOWING HAS TO BE COMPLETED BY THE ABOVEMENTIONED CANDIDATE:
1. Are you related to any recognised chief and/or head of a traditional
community? Yes/No: ..................................................................................
2. If the answer is Yes, give the name or names of any such chief and/or head
and the Traditional Authority which he or she leads:
....................................................................................................................
....................................................................................................................
....................................................................................................................
3. Do your culture, tradition, customs and languages differ from the abovementioned traditional authority/authorities? Yes /No ................................
4. If answer to question 3 is Yes, state in what respect it is different:
....................................................................................................................
....................................................................................................................
....................................................................................................................
I ..........................................................declare that the above information is, to
the best of my knowledge and belief, correct.
Signed this day..........................of .....................................at. ..........................
......................................................................
*Signature/Thumb print of candidate
*Delete whichever is not applicable
page 51