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

Regulations

Films and Publications Regulations (Games), 1999

Annexures

Annexure 4 : Prescribed form for appeal to Review Board

 

Annexure 4 : Regulation 6(a)

FPB 16/CC: Section 18 of the Films and Publications Act, 1996

 

FILM AND PUBLICATION BOARD

13th Floor Pleinpark Building Private Bag X9069 Cape Town 8000

Tel (021) 465 6518  Fax (021) 465 6511

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

(For Office Use) Ref. No.                                                                          Date Received:

 

APPEAL TO REVIEW BOARD, dated ............................................................................................

Applicant .................................................................................................................................

Address ....................................................................................................................................

Tel..................................Fax..................................E-mail..........................................................

Contact Person...........................................................................................................................

Title and Version of Game .........................................................................................................

Year of Production .............................Country of Origin .............................................................

Name of Publisher .....................................................................................................................

Details of Classification Appealed Against:  ................................................................................

...................................................................................................................................................

...................................................................................................................................................

Certificate of Classification No. ..................................................................................................

..................................................................................................................................................

Classification ...................................................Consumer Advice...............................................

..................................................................................................................................................

Date When Notified of Decision of Publication in Gazette .........................................................

Reason or Grounds of Appeal ....................................................................................................

..................................................................................................................................................

..................................................................................................................................................

..................................................................................................................................................

Signed: ......................................................................................................................................

Capacity if on behalf of a firm ....................................................................................................