. STAATSKOERANT, 9 MAART 2001 . No. 22125 15 .. C. 111 Particulars of person on whose behalf request is made r This section must be completedonly y a requestfor informution is made on beharfof another person. i Full names and surname: number: - Identity D. (a) I Particulars of record Provide full particulars of the record to which access reference numbervthat is known to you, to enable the record to be located (b) I I f the provided space is inadequateplease co,ntinueon a separatefolio and attach it to t h i s j b m The requester must sign all &headditionalfolios. 1. Descriptionofrecord or relevant part of the record: 2. Reference number, if available: 3. Any further particulars of record: I 1 - -