Statistics Act, 1999
R 385
Social Assistance Act, 2004 (Act No. 13 of 2004)RegulationsRegulations relating to the Lodging and Consideration of Applications for Reconsideration of Social Assistance Application by the Agency and Social Assistance Appeals by the Independent TribunalAnnexure A : Consolidated FormsForm 9 : Notification of Outcome of an Appeal |
FORM9
NOTIFICATION OF OUTCOME OF AN APPEAL
(Regulation 20(1))
To:
Address:
Dear Sir / Madam
Pursuant to section 18(1A) of the Social Assistance Act, 13 of 2004, this serves to inform you of the outcome of your appeal.
A. PERSONAL DETAILS OF APPLICANT OR BENEFICIARY
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Surname: |
Full Names: |
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ID Number: |
Nationality: |
Gender: M |
F |
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Tel No: |
Fax No: |
Email: |
Cell No: |
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Physical Address |
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Postal Address |
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B. DETAILS OF GRANT APPLICATION AND APPLICATION FOR RECONSIDERATION
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Agency Office: |
Date of Application:
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Date of Rejection:
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Date of Application For Reconsideration: |
Date of Rejection of Application for reconsideration |
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Type of Grant (Mark with "X") |
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Disability |
Older Persons' |
War Veteran |
Foster Child |
Care Dependency |
Child Support |
Grant in Aid |
Social Relief of Distress |
D. OUTCOME OF APPLICATION
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The outcome of your appeal is as follows:
Reasons: ......................................................................................................................... ........................................................................................................................................ ........................................................................................................................................ ........................................................................................................................................ ........................................................................................................................................ ........................................................................................................................................ ........................................................................................................................................ ........................................................................................................................................ ........................................................................................................................................ ........................................................................................................................................
CHAIRPERSON INDEPENDENT TRIBUNAL
DATE:
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