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Affidavit confirming proof of residential address To whom it may concern D MM Y Y Y Y nnnnnnnnn Date nnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnMembership no Perusal/employee/pension nosier Sir/Madam To.
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Gems forms for dependents FAQ
I wish to add him/her as my dependant on my membership of GEMS, as he/she is factually dependent on me for family care and support. He/she is not self-sufficient. He/she is under the age of 28 years and is a student and I have included proof of registration at a recognised tertiary institution.
contain all the written evidence that you want to present. be written in the first person (for example, 'I saw…', 'he said to me…') have your full name, what you do for a job and your address. be signed by you.
Financially dependent means being dependent on you for more than 50% of the child's total support.
You can fax this information to 0861 00 4367 or you can send an email to enquiries@gems.gov.za (use your membership number as a reference). You can also drop off the information at one of our GEMS walk-in centres or post it to: GEMS, Private Bag X782, Cape Town, 8000.
I hereby declare true to the best of my knowledge and belief that Smt./Sri. ___________________________________________________ aged _____________ is solely dependent on me and He/She was i.e my Father/Mother was not an employee and not having any source of income either from landed property or by way of any pension.
Factual dependents – A person who was in fact dependent on the member at the date of death for maintenance, for example, a person who lived together with the deceased as husband or wife but without being formally married to them.
Example: I, Jane Smith, swear that the information in my sworn statement is truthful to the best of my knowledge and understanding. Your statement of truth must be in the first person and you need to identify yourself in it. Keep it short and sweet.
That I am _______________ of ______________, Son/D/W/B of ___________________. That my _______________(Relationship with Applicant) __________________(Name) expired on _____________(Date of Death) at ___________(Name of place). That I am swearing this Affidavit to establish relationship with my ______________.
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