(DHA-1714A) Form 2

NOTICE OF DECISION ADVERSELY AFFECTING RIGHT OF PERSON

[Section 7(1)(g) read with section 8(3); Regulation 7(2)]

*Part C:

In relation to Inspectorate

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

At:  ...............................................................................................................................................

With reference to ................................................................................................ you are, in terms of the provisions of section 8(3) of the Act, hereby, notified that the decision is as follows:

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The reason(s) for the decision is/are the following:

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You  may, within 10 working days from date of receipt of this notice, make written representations to the Director-General to review the decision.

IMMIGRATION OFFICER'S PARTICULARS

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

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

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

Office: ......................................................................................................................................

Province: ..................................................................................................................................

SUPERVISOR'S PARTICULARS

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

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

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

I acknowledge receipt of the original of this notice and declare that I understand its content.

I *intend/do not intend to make representations to the Department in terms of section 8(2) of the Act to review the decision.

Written representations *are attached/will be submitted within 10 working days.

*Delete which is not applicable

CERTIFICATE BY INTERPRETER

I .......................................................................................................... (first name(s) and surname) of ........................................................................................................(*business/residential address) hereby confirm that I have mastered ............................................... (state language) and that I have explained to ...............................................................................the contents of this notice in the said language and that I am satisfied that the said detainee fully understands it.

Signed at .................................................... on this ................ day of ................................ 20 ..........

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Signature of interpreter