Ms

Names.

ee

ee Identity Number

990**********

q - Date of Birth

** *** **** «

Country of Birth Sex

RSA F

; Status +

CITIZEN

- -

= ~

CERTIFY THAT a DOCUMENT IS A TRU JE REPRODUCTION

a «+ OF THE ORIGINAL DOCUMEN T WHICH WAS HANDED TO ME

FOR AUTHENT! CATION FURTHER CCATIEY THAT FROM

MY OBSERVATIONS. AR NOWENT OF CRANGE WAS NOT

e i DOCUMENT

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; et

FORCE vena? 1 SSiao-t —s

> ™ feuib- ar RKAANSE POL \SIEDIENS

- YOORSIENINGSLYN BESTUUR

me

pigT RETIEF

COMMUNITY S SERVICE DENTRE _

seit im BOLE E AERVIGED

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pate of \s

44 SEP 2018

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