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No.31750 STAATSKO ERANT 2 JANUARIE 2009 DHA 32 REPUBLIC OF SOUTH AFRICA DEPARTMENT OF HOME AFFAIRS CONSENT TO MARRIAGE OF A MINOR Marriage Act 1961 Act No 25 of 1961 Reg 11II1on 9 To be completed in full and submitted althe Department of Home Affairs office The form is to be compleled in black ink with BLOCK LETTERS. Please mark with 0 tile CORRECT box. requll1ild. Appbtlol1lllhat are not legible shall not be accepted* A minor 1 deIlnlld l1li11 parson who is under the l1li8 r l18 and has no previously been married or If manied* whose mania was diHolved by eI her death or divorce. Gi1I5 under the age of 15 and b Jya under 1M age of 16 yelill1l flIquire COIIIIOnt from lMi. palllf1 s as wen as from UIe Minister r l Home Affairs. A. PARnCULARS OF MINOR 10 number Passport No* Ifforeigner Date of birth I y I Sumame 1 1 4--F i--- i -I 1 First names ill full 1 I I I Place of birth CitylTown TownMllage y I I I I I I I I Genderl I I I I Counliy of birth I I 1 I I I I I 1 I I I II I I I I I I I 1 I i Province 1 I I I Postal codel I Street I Raslden al address Marital status/ B. PARTICULARS OF OrnER PARTY TO MARRIAGE I. First names In full Residential address SIreet TownNiIlagel I y I y Iy I statusl I I - -- -- Dale 01 birth y Marital Gender j I I I I I I I J Postal code I VIllage ITown Province Country of bIrIh IY IYIY I I J Gendsrl I 1 1 I j First names 111 fun ViUage I Townb I I Marffal status I I I E* CONSENT I Ihe undersigned parent or legal guardian of the minor mentioned in section A hereby consent to the marriage J r. requll1ild. Appbtlol1lllhat are not legible shall not be accepted* A minor 1 deIlnlld l1li11 parson who is under the l1li8 r l18 and has no previously been married or If manied* whose mania was diHolved by eI her death or divorce. Gi1I5 under the age of 15 and b Jya under 1M age of 16 yelill1l flIquire COIIIIOnt from lMi. palllf1 s as wen as from UIe Minister r l Home Affairs. Gi1I5 under the age of 15 and b Jya under 1M age of 16 yelill1l flIquire COIIIIOnt from lMi. palllf1 s as wen as from UIe Minister r l Home Affairs. A. PARnCULARS OF MINOR 10 number Passport No* Ifforeigner Date of birth I y I Sumame 1 1 4--F i--- i -I 1 First names ill full 1 I I I Place of birth CitylTown TownMllage y I I I I I I I I Genderl I I I I Counliy of birth I I 1 I I I I I 1 I I I II I I I I I I I 1 I i Province 1 I I I Postal codel I Street I Raslden al address Marital status/ B. A. PARnCULARS OF MINOR 10 number Passport No* Ifforeigner Date of birth I y I Sumame 1 1 4--F i--- i -I 1 First names ill full 1 I I I Place of birth CitylTown TownMllage y I I I I I I I I Genderl I I I I Counliy of birth I I 1 I I I I I 1 I I I II I I I I I I I 1 I i Province 1 I I I Postal codel I Street I Raslden al address Marital status/ B. PARTICULARS OF OrnER PARTY TO MARRIAGE I. First names In full Residential address SIreet TownNiIlagel I y I y Iy I statusl I I - -- -- Dale 01 birth y Marital Gender j I I I I I I I J Postal code I VIllage ITown Province Country of bIrIh IY IYIY I I J Gendsrl I 1 1 I j First names 111 fun ViUage I Townb I I Marffal status I I I E* CONSENT I Ihe undersigned parent or legal guardian of the minor mentioned in section A hereby consent to the marriage J r.

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