- Click here for help...
- Field is empty or invalid
ANNEXURE B IN TERMS OF NOTICE 187 OF GOVERNMENT GAZETTE OF 15 FEBRUARY 2002

FORM C

NOTICE OF INTERNAL APPEAL


(Section 75 of the Promotion of Access to Information Act, 2000 (Act No. 2 of 2000))
[Regulation 6]

Form Reference
Click here for help...
  NOTE: A person who lodges an internal appeal may have to pay an appeal fee. If an appeal fee is payable, the decision of the internal appeal may be deferred until the fee is paid.
  A. Particulars of public body
The Information Officer/
Deputy Information Officer
Click here for help...
  B. Particulars of requester/3rd party who lodges the appeal
  (a) The particulars of the person who is lodging theappeal must be completed below.
(b) Proof of the capacity in which appeal is lodged, if applicable, must be attached.
(c) If the appellant is a third person and not the person who originally requested the information, the particulars of the requester must be stated at (C) below.
Full Names and Surname
Click here for help...
Identity Number
Click here for help...
Postal Address
Click here for help...
Fax Number
Telephone Number
Click here for help...
EMail Address
Click here for help...
Capacity in which an internal appeal on behalf of another person is lodged
Click here for help...
  C. Particulars of requester
  This section must be completed ONLY if a third party (other than the requester) is lodging the internal appeal
Full Names and Surname
Click here for help...
Identity Number
Click here for help...
  D. The decision against which the internal appeal is lodged
Select the decision against which the internal appeal is lodged in the appropriate box




  E. Grounds for appeal
  IF THIS FORM IS PRINTED OUT AND SUBMITTED MANUALLY:
If the provided space is inadequate please continue on a separate folio and attach it to this form. You must sign all the additional folios.
If attachments need to be send electronically, please forward it via email to us and quote the Reference Number.
State the grounds upon which the internal appeal is based
Click here for help...
State any other information that may be relevant in considering the appeal
Click here for help...
  F. Notice of decision on appeal
  You will be notified in writing of the decision on your internal appeal.
If you wish to be informed thereof in another manner, please specify the manner and provide the necessary particulars to enable compliance with your request.
State the Manner
Particulars
Submitted at
Click here for help...
Full Names of Appellant
Secure form

© North-West University. All Rights Reserved www.summanet.co.za
SNForms Portal - v2.3 © 2015 Summa Networks