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Judicial Service Commission Act, 1994 (Act No. 9 of 1994)

Regulations

Disclosure of Registrable Interests

Annexures

Annexure B

Form 1

 

Annexure B

 

Form 1

Regulations Relating to the Judicial Service Commission Act, 1994

 

Disclosure of Registrable Interests

[Regulation 3]

 

File number :.......................

Please note:

1. This form must be completed in block letters.
2. Failure to comply with any provision in Regulation 3, or the disclosure of false or misleading information, may result in the lodging of a complaint contemplated in section 14 of the Act.
3. Proof of Minister's consent, granted in terms of section 11 of the Act, must be attached, where applicable.

 

 

A.

 

PERSONAL PARTICULARS OF JUDGE

(To be completed by every judge referred to in regulation 2(1))

 

Surname:

 

Full names:

 

Identity number

 

Court where serving (only in case of judge in active service [or acting]):

 

Postal address:

 

Telephone (h):

(   )

Telephone (b):

(   )

Cellular phone nr:

 

Facsimile nr:

(   )

E-mail address:

 

Please indicate service status:

Active service

 

Discharged: ....... years of age

 

B.

 

PARTICULARS OF IMMEDIATE FAMILY MEMBER(S)

(To be completed by judges in active service if disclosure is to be made. Please attach separate page if more than two family members have registrable interests.)

 

1. Surname:

 

Full names:

 

Identity number

 

Relationship to judge:

2. Surname:

 

Full names:

 

 

 

Identity number

 

Relationship to judge:


C.

 

PARTICULARS OF INTERESTS DISCLOSED

 

1.

OWNERSHIP OR CO-OWNERSHIP OF IMMOVABLE PROPERTY

(To be disclosed by judges in active service. Please indicate if disclosure is made in respect of immediate family members.)

DESCRIPTION

LOCATION

VALUE

REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

SHARES

(To be disclosed by all judges required to make disclosures in terms of regulation 2(1). Please indicate if disclosure is made in respect of immediate family members.)

NATURE

NOMINAL VALUE

COMPANY/ENTITY

REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

DIRECTORSHIPS, BUSINESS OR FINANCIAL INTERESTS IN ANY BUSINESS ENTERPRISE OR ANY LEGAL ENTITY

(To be disclosed by all judges required to make disclosures in terms of regulation 2(1). Please indicate if disclosure is made in respect of immediate family members.)

NAME OF ENTITY

TYPE OF BUSINESS

INCOME/BENEFIT DERIVED

REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

ROYALTIES, INCOME OR OTHER BENEFITS DERIVED FROM THE APPLICATION OF SECTION 11 OF ACT 9 OF 1994

((To be disclosed by all judges required to make disclosures in terms of regulation 2(1).)

NATURE OF BENEFIT

VALUE

PARTICULARS OF MINISTERIAL CONSENT

REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

SPONSORSHIPS

(Only in respect of immediate family members, if applicable, by judges in active service.)

SOURCE OF SPONSORSHIP

NATURE OF SPONSORSHIP

NOMINAL VALUE

REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

GIFTS AND HOSPITALITY

(To be disclosed by judges required to make disclosures in terms of regulation 2(1). Please indicate if disclosure is made in respect of immediate family members.)

SOURCE OF GIFT/HOSPITALITY

DESCRIPTION OF GIFT/HOSPITALITY

NOMINAL VALUE

REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

ANY OTHER FINANCIAL INCOME NOT DERIVED FROM HOLDING JUDICIAL OFFICE

(To be disclosed by all judges required to make disclosures in terms of regulation 2(1).)

SOURCE OF INCOME

NATURE OF INCOME

NOMINAL VALUE

REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I, the undersigned ................................ (name of judge) hereby certify that the above information is complete and correct to the best of my knowledge.

 

 

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

 

 

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

Signature of judge