S.L. 389.2 Art. 115. 6. 7. 12. I best of my with the Commissioner 12.1 6 and 17

List of Documents Applicants are to list the documents attached to this application.

1. ................................................. 2. ................................................. 3. .................................................

4. ................................................. .................................................

................................................. ................................................. Applicant’s declaration hereby declare that the information contained in this application is, to the knowledge and belief, true and correct, and I undertake that in accordance provisions of article 12(1)(c) of the Act, I shall immediately inform the of any change in the information herein contained. Applicant’s name .................................................. Designation ..........................................................

Signature .............................................................. THIRD SCHEDULE

(Regulation 7(1))

Private Guards and Community Officers Act Application for a licence of a Community Officer in terms of articles