(DHA-1714A) Form 2

NOTICE OF DECISION ADVERSELY AFFECTING RIGHT OF PERSON

[Section 10, read with section 8(3); Regulation 7(2)]

*Part B:

In relation to permitting

Ref No.

To: .........................................................................

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With reference to your application for a ........................................................................, dated ......................................., you are, in terms of the provisions of section 8(3) of the Act, hereby, notified that the decision is as follows:

REFUSED

The reason(s) for the decision is/are the following:

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You may, within 10 working days from date of receipt of this notice, make written representations to the Director-General to review the decision.

Should you fail to make representations, or fail to keep the Department informed of your whereabouts, the decision set out above shall remain effective. it is your responsibility to enquire about the outcome of your representations within 30 days after submission thereof.

I acknowledge receipt of the original of this notice and declare that I understand its content.

I *intend/do not intend to make representations to the Department in terms of section 8(2) of the Act to review the decision.

Written representations *are attached/will be submitted within 10 working days.

*Delete which is not applicable

CERTIFICATE BY INTERPRETER

I .............................................................................................................................................. (first name(s) and surname) of ...................................................................................................... (*business/residential address) hereby confirm that I have mastered ......................................................... (state language) and that I have explained to .............................................................................................. the contents of this notice in the said language and that I am satisfied that the said detainee fully understands it.

Signed at ........................................ on this ................. day of ..................................... 20 ..............

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Signature of interpreter