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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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How to fill out the Gems Affidavit online

The Gems Affidavit is an important document for confirming proof of residential address for members of the Government Employees Medical Scheme (GEMS). This guide will walk you through the steps needed to complete the affidavit online, ensuring that all required information is accurately provided.

Follow the steps to complete the Gems Affidavit online:

  1. Press the ‘Get Form’ button to access the Gems Affidavit and open it in your preferred editor.
  2. In the first section, enter the date by selecting or typing the day, month, and year accurately.
  3. Locate the 'Membership number' field and input your membership number as required.
  4. Next, fill in your 'Persal/employee/pension number' so that it corresponds to your records.
  5. In the section labeled 'Dear Sir/Madam,' begin by entering your full name as the main member of GEMS.
  6. Provide your identification number by entering it in the 'ID no' field.
  7. Complete the residential address section; ensure all address lines are filled out completely, including the postal code.
  8. On the line labeled 'Thus declared on this,' enter the day and month of the declaration, followed by the year.
  9. In the final section, sign the form where indicated, acknowledging that you understand the contents of the declaration.
  10. After completing the form, you may save your changes, download, print, or share the affidavit as necessary.

Complete your Gems Affidavit online today to ensure your residential address is properly verified.

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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 ______________.

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.

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.

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.

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.

Financially dependent means being dependent on you for more than 50% of the child's total support.

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.

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.

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