Parental Consent Affidavit Form - Republic Of South Africa (Page 2 of 2) in pdf

Parental Consent Affidavit Form - Republic Of South Africa Page 2

Annexure C

Legal Guardian:

Surname, Name

Residential Address

Work Address

Contact no. Work

Mobile

Residence

Signature

Date

Attach legal guardian’s appointment letter or court order and ID or passport.

Copies of the following documents are attached:

Unabridged Birth Certificate (UBC) or Equivalent Document of child travelling

ID or Passport and Visa of person receiving child in the Republic

Court Order (where applicable)

Death Certificate (of any deceased parent reflected on the UBC or Equivalent Document)

ID or Passport of parent(s) or legal guardian(s)

Thus signed and **sworn/solemnly affirmed before me on this …………. day of

… … … … … … … …..20…… …… .

OFFICE

… … … … …… … ………… ………… ………… …… ….

STAMP

Commissioner of Oaths

(May be attested free of charge at any embassy or mission of the Republic of South Africa)

First name(s): … … … … … … … … … … … … … … …

Surname: … … …… … …… …… …………… ………

Capacity: …………………………………………….

Place: … … … … …… …… …………… ………… ……

Contact Number: ……………………………………

*Both parents whose details appear on the UBC or Equivalent Document shall consent to the child’s travel.

Where only one parent’s details appear, only such parent’s consent is required.

**Delete whichever is not applicable.

***An Equivalent Document is any official document or letter issued by a foreign government (including a foreign embassy)

or a letter issued by the Director-General of the Department of Home Affairs in lieu of an unabridged birth certificate and

which serves as a confirmation of parentage of a person below the age of 18.

****This document remains valid only for the period stipulated.

Parental Consent Affidavit Form - Republic Of South Africa Page 2