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    Affivadit For CDG v1.2

    Uploaded by

    khwezishezi35
    The document is an affidavit for applying for a Care Dependency Grant for a child, where the applicant provides their personal details and relationship to the child. It requests information about the applicant and spouse/partner's income sources and marital status. The applicant declares that the information provided is true and the affidavit is signed and stamped by a Commissioner of Oaths.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Affivadit For CDG v1.2

    Uploaded by

    khwezishezi35
    20 views1 page
    The document is an affidavit for applying for a Care Dependency Grant for a child, where the applicant provides their personal details and relationship to the child. It requests information about the applicant and spouse/partner's income sources and marital status. The applicant declares that the information provided is true and the affidavit is signed and stamped by a Commissioner of Oaths.

    Original Description:

    Child grant form from sassa

    Original Title

    Affivadit for CDG v1.2

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    The document is an affidavit for applying for a Care Dependency Grant for a child, where the applicant provides their personal details and relationship to the child. It requests information about the applicant and spouse/partner's income sources and marital status. The applicant declares that the information provided is true and the affidavit is signed and stamped by a Commissioner of Oaths.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    20 views1 page

    Affivadit For CDG v1.2

    Uploaded by

    khwezishezi35
    The document is an affidavit for applying for a Care Dependency Grant for a child, where the applicant provides their personal details and relationship to the child. It requests information about the applicant and spouse/partner's income sources and marital status. The applicant declares that the information provided is true and the affidavit is signed and stamped by a Commissioner of Oaths.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    ANNEXURE I-5

    AFFIDAVIT FOR A CARE DEPENDENCY GRANT

    I, the undersigned
    Surname .
    Full names .
    Identity Number . Age

    Residing at
    (physical address)
    Postal Code
    Do hereby state under oath that I am applying for a Care Dependency Grant for the following child:
    Name & Date of
    C C Y Y M M D D
    Surname Birth
    Name of Clinic / Hospital ID number
    where child was born: of Child
    I am the parent* / foster parent* / primary care giver* of the child mentioned above and he / she resides with me. (* delete that which is not
    applicable) I confirm that the child is not in an institution funded by the state.
    Marital Status (mark appropriate box with X)
    Married Unmarried
    Out of Customary Asiatic Deserted > 3
    In community Civil Union Never Married Divorced Widow / Widower
    community Union Religion months

    To be completed if Married / Divorced / Widow(er)

    My (ex) spouse / partner’s full Names & Surname


    ID
    State reasons if applicant does not have any of the following documents for his/her (ex) spouse or partner.
    ID Document Decree of Divorce Death Certificate
    Reason Reason Reason
    Reason Reason Reason
    Sources of Income (mark X in applicable box)
    Dependant
    Type of income / Profits Self Spouse
    Child
    N/A

    Salary or wage
    Profits, Withdrawals or other Benefits from a Business / Farm (owned)
    Payments from a Trust or Inheritance
    Payment from Property Rights
    Pension or Annuity
    Ex-Gratia Payments Received
    Maintenance Received
    Rental Income
    Profits, Withdrawals, or other Benefits from a Business / Farm (rented)
    Income from Assets (interest / dividends)
    Income from any RSA or International Organisation
    If the applicant and / or spouse have NO source of income, please indicate below how he / she currently survive

    Declaration
    I declare that all information furnished in this affidavit is to the best of my knowledge true and correct. I have no objection to taking the
    prescribed oath and I consider the prescribed oath to be binding on my conscience.
    I certify that the deponent
    has acknowledged that he / Commissioner /
    she knows and understand
    the contents of this
    SAPS
    Name of Commissioner
    declaration that was sworn to Stamp
    and affirmed before me and
    that the deponent’s signature
    / thumb print was placed in
    Deponent’s Signature / my presence. Signature:
    Rank / Force No.
    Thumb Print Commissioner of Oaths

    Date C C Y Y M M D D Place

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