(DHA-1721) Form 23

NOTICE BY IMMIGRATION OFFICER TO PERSON TO APPEAR BEFORE DIRECTOR-GENERAL

[Section 7(1)(g) read with section 33(4)(c); Regulation 32(3)]

To: ............................................................................................................................................................................................................................................

(name(s) and surname) with identity document / passport number ..........................................................................................................................................

Tel No. : ......................................................................................(work/home)                                Cell No. : ...............................................................................

Alternative Contact: ...............................................................................................................................................(next of kin, friend's name and surname)

Tel No.: .......................................................................................(work/home)                                Cell No.: ...............................................................................

E-mail address: .............................................................................................

YOU ARE HEREBY called upon in terms of section 33(4)(c) of the Act to appear before ............................................................................................................................(name(s) and surname of immigration officer) at ..............................................................................................................................................................................................(physical address) on ................................................................................ (date) at ..................................................................... (time).

Reason(s) why you are called upon to appear before the Director-General:

.........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

..........................................................................                                      ....................................................                                     .........................................

Signature of *immigration officer/sheriff                                                      Appointment no                                                                           Date

IMMIGRATION OFFICER'S PARTICULARS

Name and Surname: ................................................................................................................................................................................................

Appointment number: ............................................................................................................................................................................................

Rank/position .........................................................................................................................................................................................................

Office: ............................................................................................ Province : ........................................................................................................

SUPERVISOR'S PARTICULARS

Name and Surname: ................................................................................................................................................................................................

Rank/position .........................................................................................................................................................................................................

Contact No.: Tel: .....................................................................................................................................................................................................

A copy hereof was personally handed to the aforementioned on ..........................................................................................(date) and the import thereof explained to him or her/ delivered at his/her last known address*.

Place: .....................................................................................................................................................................................................................

....................................................................................                     .....................................................                                     ...........................................

Signature of *immigration officer/sheriff                                                  Appointment no                                                                            Date

IMMIGRATION OFFICER'S PARTICULARS

Name and Surname: ................................................................................................................................................................................................

Appointment number: ............................................................................................................................................................................................

Rank/position .........................................................................................................................................................................................................

Office: ............................................................................................ Province : ........................................................................................................

SUPERVISOR'S PARTICULARS

Name and Surname: ................................................................................................................................................................................................

Rank/position .........................................................................................................................................................................................................

Contact No.: Tel : .....................................................................................................................................................................................................

ACKNOWLEDGEMENT OF RECEIPT

I acknowledge receipt of this notice.

.........................................................                             ..................................................................................                           .............................................

Signature of recipient                                                               Initials and Surname                                                                                                   Date

*Delete which is not applicable