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Get Ethekwini Municipality Claim Form

F CLAIMANT: Full Name: Address. Telephone No. Electricity Acc. No. (if appl.) ID. Number: Home: Work: Cell: MOTOR VEHICLE ACCIDENT ( IF APPLICABLE). Claimant s Vehicle Reg. Driver of Vehicle: Municipal Vehicle Reg. No. Municipal Driver: Department: Name of Police Station: Ref. Number: DETAILS OF OTHER ACCIDENT/INCIDENT: Date and time of accident/incident: Place of Accident/Incident: Names & addresses of witnesses: Telephone Numbers: Details of Accident/Incident. Home: Work: State how.

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