Private Security Industry Regulation Act, 2001 (Act No. 56 of 2001)RegulationsRegulations Relating to Appeals and Applications for Exemptions, 2003Annexure : Form for Lodging an Appeal |
ANNEXURE
FORM FOR LODGING AN APPEAL
PRIVATE SECURITY INDUSTRY REGULATION ACT, 2001 (ACT NO. 56 OF 2001)
REFERENCE NUMBER
(for official use)
1. | PARTICULARS OF APPELLANT |
1.1 | Full name (and name of natural person acting on behalf of a security business which appeal) |
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1.2 | Contact address for correspondence on the appeal |
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1.3 | Contact telephone and fax numbers and other electronic contact particulars |
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1.4 | Registration number as security service provider (if any) |
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1.5 | Name, capacity and contact particulars of person submitting or preparing an appeal on behalf of the appellant |
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2. NATURE OF DECISION APPEALED AGAINST
(Make cross in the appropriate box)
2.1 |
Refusal to grant application for registration |
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2.2 |
Refusal to grant application for renewal of registration |
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2.3 |
Cancellation of renewal of registration |
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2.4 |
Suspension of registration |
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2.5 |
Withdrawal of registration |
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2.6 |
Conviction of improper conduct |
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2.7 |
Penalty imposed in consequence of finding of improper conduct |
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2.8 |
Other decision - describe |
3. | SUMMARY OF PARTICULARS OF DECISION APPEALED AGAINST |
Provide a brief description of the decision appealed against, mentioning the person taking the decision and the date of the decision (if this is known to the appellant)
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4. | SUMMARY OF GROUNDS OF APPEAL |
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5. | DOCUMENTS THAT SHOULD BE ATTACHED TO THIS FORM (DEPENDING ON THE FACTS AND CIRCUMSTANCES) |
5.1 |
True copy of resolution of security business authorising the lodging of the appeal |
5.2 |
True copies of all documents received from the Authority in respect of the decision appealed against |
5.3 |
True copies of record of improper conducts enquiry and all exhibits admitted at the enquiry |
5.4 |
A document containing full and clear details of the grounds of appeal and the arguments and representations submitted by the appellant (including factors in mitigation of punishment, if applicable) |
6. | LIST OF DOCUMENTS ATTACHED BY THE APPELLANT TO THIS FORM |
Provide a complete list of all documents attached to the form
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7. SIGNATURE OF APPELLANT AND DATE OF SUBMISSION TO THE AUTHORITY
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Important note:
In terms of section 38(3)(c) of the Private Security Industry Regulation Act 56 of 2001, any person who in any application, inquiry, improper conduct proceedings, appeal or other proceedings in terms of this Act or the Levies Act, wilfully furnishes, information or makes a statement which is false in any material respect, is guilty of an offence and liable to a heavy fine or to imprisonment for maximum period of 2 years. |