PAIA Request Form

Request for Access to Record of Private Body (Section 53(1) of the Promotion of Access to Information Act, 2000).

A. Particulars of Private Body

The Head: ULegacy (Pty) Ltd

B. Particulars of Person Requesting Access

The particulars of the person who requests access to the record must be given below.

Full Names and Surname

Identity Number

Postal Address

Fax Number

Telephone Number

E-mail Address

Capacity in which request is made, when made on behalf of another person:

C. Particulars of Person on Whose Behalf Request is Made

This section must be completed ONLY if a request for information is made on behalf of another person.

Full Names and Surname

Identity Number

D. Particulars of Record

Provide full particulars of the record to which access is requested.

Description of record or relevant part of the record:

Reference number, if available:

Any further particulars of record:

E. Fees

A request for access to a record, other than a record containing personal information about yourself, will be processed only after a request fee has been paid.

You will be notified of the amount required to be paid as the request fee.

F. Form of Access to Record

If you are prevented by a disability to read, view or listen to the record...

Disability:

Form in which record is required:

Mark the appropriate box with an X:

Copy of record

Inspection of record

Record in electronic form