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Films and Publications Act, 1996 (Act No. 65 of 1996)

Regulations

Films and Publications Regulations, 2014

Annexures

Annexure F : Board/GM

 

Annexure F

BOARD/GM

FILM AND PUBLICATION BOARD

420 WITCH HAZEL, ECO GLADE 2, ECO PARK

CENTURION 0169

PRIVATE BAG X 31, HIGHVELD 0169

E-MAIL:[email protected]

Website: www.fpb.org.za

 

Request for classification of games

[regulation 16]

 

The Film and Publication Board may refuse to process your application if this form is not fully completed

 

Ref No (Office use)


 

DATE OF APPLICATION


DATE RECEIVED (Office use)


 

APPLICANT


 

POSTAL ADDRESS



POSTAL CODE


 

CONTACT PERSON


 

TEL


FAX


E-MAIL


 

TITLE OF GAME


COUNTRY OF ORIGIN


YEAR OF PRODUCTION


PUBLISHER


GENRE


 

FORAMAT

PC


CONSOLE


ARCADE


MOBILE GAME


OTHER


 

PROOF OF RIGHT TO DISTRIBUTE GANE IN THE REPUBLIC OF SOUTH AFRICA


 

DESCRIPTION OF GAME PLAY AND TARGET MARKET

ORIGINAL


ADD-ON


COMPILATION


BUDGET-LINE





 

ELSPA RATING


REASON FOR RATING


 

ESRB RATING


REASON FOR RATING



SIGNED


DATE


CAPACITY


 

NOTE:

 

1. Proof of your right to distribute or exhibit this game in South Africa, in the format submitted, must be attached to this form.
2. Unless exempted from the cash-on-submission basis, payment in full of the applicable amount must be made before this application may be processed. Where payment has been made by direct deposit into the account of the Board, proof of such deposit must be attached to this form.
3. You must provide, free of charge, a copy of this game, to the Board for its records.