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    Affivadit CSG

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    jeswynnemartin67
    This document is an affidavit for applying for a child support grant. It contains information such as the applicant's name and ID number, marital status, sources of income, and a declaration that the information provided is true. If married, divorced, or a widow/widower, it requests details of the ex-spouse or partner such as their name and ID. It is signed by the applicant and a Commissioner of Oaths to certify the accuracy of the information.

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

    Affivadit CSG

    Uploaded by

    jeswynnemartin67
    22 views1 page
    This document is an affidavit for applying for a child support grant. It contains information such as the applicant's name and ID number, marital status, sources of income, and a declaration that the information provided is true. If married, divorced, or a widow/widower, it requests details of the ex-spouse or partner such as their name and ID. It is signed by the applicant and a Commissioner of Oaths to certify the accuracy of the information.

    Original Title

    Affivadit_CSG

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    © © All Rights Reserved

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    This document is an affidavit for applying for a child support grant. It contains information such as the applicant's name and ID number, marital status, sources of income, and a declaration that the information provided is true. If married, divorced, or a widow/widower, it requests details of the ex-spouse or partner such as their name and ID. It is signed by the applicant and a Commissioner of Oaths to certify the accuracy of the information.

    Copyright:

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

    Affivadit CSG

    Uploaded by

    jeswynnemartin67
    This document is an affidavit for applying for a child support grant. It contains information such as the applicant's name and ID number, marital status, sources of income, and a declaration that the information provided is true. If married, divorced, or a widow/widower, it requests details of the ex-spouse or partner such as their name and ID. It is signed by the applicant and a Commissioner of Oaths to certify the accuracy of the information.

    Copyright:

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

    ANNEXURE I-4

    AFFIDAVIT FOR A CHILD SUPPORT 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 Child Support Grant for the following child:
    Name & Date of
    C C Y Y M M D D
    Surname Birth
    Note: Attach list with additional children’s names if application is for more than one child.
    Name of Clinic / Hospital ID number
    where child was born: of Child
    I am the primary care giver* / biological parent* of the child mentioned above and he / she resides with me. I am not being paid to care
    for the child mentioned above, and confirm that the child does not reside in a State Funded Institution. (* delete that which is not applicable)
    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)
    Self Spouse Dependant N/A
    Type of Income / Profits Child
    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 /
    she knows and understand
    the contents of this Name of Commissioner
    declaration that was sworn to Commissioner /
    and affirmed before me and
    that the deponent’s signature SAPS
    / thumb print was placed in
    Deponent’s Signature / Signature:
    my presence. Rank / Force No.
    Thumb Print Commissioner of Oaths
    Stamp
    Date C C Y Y M M D D Place

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