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Spatial Data Infrastructure Act, 2003 (Act No. 54 of 2003)

Regulations

Spatial Data Infrastructure Regulations, 2017

Forms

Form C : Declaration by Persons Nominated for Consideration as Members of the Committee for Spatial Information

 

FORM C :

DECLARATION BY PERSONS NOMINATED FOR CONSIDERATION AS MEMBERS OF THE COMMITTEE FOR SPATIAL INFORMATION

 

I,                                                                                     (name), ID No                                                                      hereby declare that I am not mentally ill or mentally incapacitated, am not an unrehabilitated insolvent and does not have a criminal record as contemplate in section 8(1)(a), (b) and (c) of the Spatial Data Infrastructure Act, 2003, and I authorise the Minister of Rural Development and Land Reform to investigate any record in relation to any possible disqualification or requirement.

 

Surname:

 

Full names:

 

ID Number:












 

Gender:

Race:

 

Citizenship:

 

Organisation:

 

Work Number:

 

Cellphone Number:

 

Email Address:

 

 

 

Signature of Committee Member:                                                                                

 

Date:                                                                                

 

Witness 1:

Name

Organisation:

Signature:

Date:

Witness 2:

Name:

Organisation:

Signature:

Date:

 

(By signing this declaration form, the signee understands that any false declaration may lead to immediate suspension from the Committee and the signee may be held accountable.)