Military Veterans Database Information Form - Republic Of South Africa Page 4
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4MILITARY VETERANS DATABASE INFORMATION
BARCODE:
DMVF-
FORM
CONFIDENTIAL WHEN COMPLETED
þ
- Where applicable
6.
Certified copies of the following documentation must be attached
to the completed form:
a.
Veteran’s RSA Identity Document (If veteran is deceased, his/her Death Certificate).
b.
Veteran’s Marriage Certificate.
c.
Spouse’s ID and Children’s Birth Certificates/ID Documents.
d.
Certificate of Service (If you do not have a Force Number/CPR Number).
e.
Educational Qualifications.
f.
Drivers License.
g.
Homeowners - deed of Trust of your home.
h.
Proof of Residence.
i.
Proof of Registration and Tax Clearance Certificate of your Business.
IT IS A CRIMINAL OFFENCE TO COMPLETE FALSE INFORMATION ON THE REGISTRATION FORM AND ANY PERSON FAILING TO PROVIDE
TRUE INFORMATION MAY BE FOUND GUILTY OF A CRIMINAL OFFENCE OR MAY BE LIABLE TO A FINE.
I DECLARE THAT ALL THE INFORMATION PROVIDED (INCLUDING ANY ATTACHMENTS) ARE COMPLETE AND CORRECT TO THE BEST OF
MY KNOWLEDGE, AND THAT THE INFORMATION IS SUPPLIED VOLUNTARILY.
MILITARY VETERAN/DEPENDANT SIGNATURE
DATE
FOR OFFICE USE ONLY:
COMPILER:
DATA CAPTURER:
CHECKER
NO:
_______________________
NO:
_______________________
NO:
_______________________
RANK:
_______________________
RANK:
_______________________
RANK:
_______________________
INITIALS & SURNAME:
INITIALS & SURNAME:
INITIALS & SURNAME:
VENUE/UNIT WHERE FORM WAS COMPLETED:
I CONFIRM THAT DATA CAPTURED IS ACCURATE
I CONFIRM THAT DATA CAPTURED IS ACCURATE
AND MIRRORS DATA PROVIDED IN THE MILITARY
AND MIRRORS DATA PROVIDED IN THE MILITARY
VETERANS’ REGISTRATION FORM:
VETERANS’ REGISTRATION FORM:
YES
NO
YES
NO
DATE:
DATE:
DATE:
SIGNATURE:
SIGNATURE:
SIGNATURE:
REGISTER SERIAL NUMBER:
__________________________________
THIS FORM IS SUPPLIED FREE OF CHARGE BY THE DEPARTMENT OF MILITARY VETERANS AND IS NOT FOR SALE
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