Medicines and Related Substances Act, 1965
R 385
Broad-Based Black Economic Empowerment Act, 2003 (Act No. 53 of 2003)NoticesApplication for Market Access Permits for Agricultural Products in terms of the World Trade Organisation (WTO) Agreement for 2022AnnexuresAnnexure A : Application Form for Import Permits for the Calendar Year 2022 |
AFFIDAVIT
I the undersigned ________________________________________________________________
do hereby make oath / affirmation and declare that:
| 1. | I am duly authorized to depose to this affidavit on behalf of the applicant; and |
| 2. | The particulars contained in the application form are true and correct. |
SIGNED at _____________________________________on this _______ day of
________________ 2021/22
_____________________
DEPONENT
(to be signed in the presence of a Justice of the Peace or Commissioner of Oaths)
| 1. | I certify that before administering the oath/affirmation, I asked the deponent the following questions and wrote down his/her answers in his/her presence. |
| (1) | Do you know and understand the contents of the declaration? |
Answer ……………………………………………………………………………………….
| (2) | Do you have any objection to taking the prescribed oath/affirmation? |
Answer ……………………………………………………………………………………...
| (3) | Do you consider the prescribed oath/affirmation to be binding on your conscience? |
Answer……………………………………………………………………………….........
| 2. | I certify that the deponent has acknowledged that he/she knows and understands the contents of this declaration. The deponent utters the following words: “I swear that the contents of this declaration are true so help me God” / “I truly affirm that the contents of the declaration are true.” |
The signature/mark of the deponent is affixed to the declaration in my presence
…………………………………………………………………………….........
JUSTICE OF THE PEACE
COMMISSIONER OF OATHS
TO BE COMPLETED BY THE JUSTICE OF THE PEACE/COMMISSIONER OF OATHS:
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FULL FIRST NAMES AND SURNAME (BLOCK LETTERS)
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_________________________ |
|
DESIGNATION:
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_________________________ |
|
PHYSICAL ADDRESS:
|
_________________________ |
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DATE:
|
_________________________ |
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PLACE:
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_________________________ |
PLEASE COMPLETE THE ABOVE AFFIDAVIT WHICH IS AN INSEPARABLE PART OF THE APPLICATION FORM AND MUST BE SUBMITTED WITH EACH QUARTERLY, HALF-YEARLY OR ANNUAL APPLICATION
