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GENERAL POWER OF ATTORNEY (Please complete form in FULL)
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GRANTOR'S DETAILS
Who is the person that will be granting the Power of Attorney?
Full Name:
Is the Grantor a South African citizen?
Yes
No
ID Number:
Date of Birth:
Passport Number:
Telephone (W):
Telephone (H):
Telephone (Cell):
Email
Physical Address:
Address 1:
Address 2:
Suburb:
City:
Postal Code:
Province:
-- Click to Select --
Eastern Cape
Free State
Gauteng
Kwazulu-Natal
Limpopo
Mpumalanga
North West Province
Northern Cape
Western Cape
Check this box if the postal address is different
Postal Address:
Address 1:
Address 2:
Suburb:
City:
Postal Code:
Province:
-- Click to Select --
Eastern Cape
Free State
Gauteng
Kwazulu-Natal
Limpopo
Mpumalanga
North West Province
Northern Cape
Western Cape
GRANTEE'S DETAILS
Who is the person that will be granting the Power of Attorney?
Full Name:
Is the Grantee a South African citizen?
Yes
No
ID Number:
Date of Birth:
Passport Number: