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

Regulations

Purchase

Annexure N

BOARD/LF

FILM AND PUBLICATION BOARD

420 WITCH HAZEL, ECO GLADE 2, ECO PARK

CENTURION 0169

PRIVATE BAG X 31, HIGHVELD 0169

Website: www.fpb.org.za

APPLICATION FOR LIST OF CLASSIFIED FILMS, GAMES & PUBUCATIONS

[regulation 30]

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

FILM/PUBLIC/GAME

DATE OF APPLICATION

DATE RECEIVED (Office use)

APPLICANT

POSTAL ADDRESS
		POSTAL CODE

CONTACT PERSON

TEL

FAX

E-MAIL

PREFERRED METHOD OF DELIVERY

SIGNED

DATE

CAPACITY

*Attach proof of payment of prescribed fee