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AFFIDAVIT - Justice Home

DEPARTMENT OF Justice AND CONSTITUTIONAL DEVELOPMENT GP-S 81/811521 J192 (81/811521) REPUBLIC OF SOUTH AFRICA AFFIDAVIT PARTICULARS OF NEXT-OF-KIN I, .. *do hereby make oath and say/affirm that within is a true and complete statement of the next-of-kin of the deceased, and I make this statement conscientiously, believing the same to be true.. Signature Print Name and Surname Signed and *sworn to/affirmed before me day in the year. The deponent has acknowledged that he/she knows and understands the contents of this AFFIDAVIT and adheres to it.. *Magistrate/ Justice of the Peace/Commissioner of Oaths Area for which appointed .. If appointment is held ex officio, state office * Delete if not applicable.

J192 DEPARTMENT OF JUSTICE AND CONSTITUTIONAL DEVELOPMENT 2 * Separate affidavits in respect of each predeceased child must be completed. Names and addresses of the next-of-kin of the late.....

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