Form BI 63 - South Africa
Form BI 63 - South Africa
Form BI 63 - South Africa
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G.P.-S. 017-0422<br />
REPUBLIC OF SOUTH AFRICA<br />
DEPARTMENT OF HOME AFFAIRS<br />
APPLICATION FOR FOR AA CERTIFICATE OF OF NATURALISATION<br />
(Section<br />
(Section<br />
5: <strong>South</strong><br />
5: <strong>South</strong><br />
<strong>Africa</strong>n<br />
<strong>Africa</strong>n<br />
Citizenship<br />
Citizenship<br />
Act,<br />
Act,<br />
1995)<br />
1995)<br />
<strong>BI</strong>-<strong>63</strong><br />
WARNING:<br />
Directions:<br />
Penalty for false representations or statement.<br />
Any person who makes for any of the purposes of this Act, any false representation or any statement which is false in any material<br />
particulars, shall be guilty of an offence and liable on conviction to a fine or to imprisonment for a period not exceeding eight years.<br />
The form must be completed in BLOCK letters, and signed at the bottom of page.<br />
PART I<br />
PERSONAL PARTICULARS OF APPLICANT<br />
Surname.................................................................................................... Maiden name .......................................................................................................<br />
First names (in full) ..................................................................................................................................................................................................................<br />
Identity No. ................................................................................................ Date of birth<br />
Place of birth ............................................................................................. Nationality ............................................................................................................<br />
Employer (name and address) ................................................................................................................................................................................................<br />
Present residential address .....................................................................................................................................................................................................<br />
Postal address .........................................................................................................................................................................................................................<br />
Tel. No. ...................................................................................................... Tel No. (employer)................................................................................................<br />
PARTICULARS OF RESIDENCE IN SOUTH AFRICA<br />
Date of entry Immigration Permit No. ..................................... Date of issue<br />
Periods of absence from <strong>South</strong> <strong>Africa</strong> since entry. State exact date of absence.<br />
From To Reasons for absence<br />
RECORDS OF CONVICTIONS (IF ANY)<br />
Have you ever been convicted of any crime or offence?<br />
If so, give particulars below.<br />
Yes<br />
No<br />
Nature of crime or offence Sentence Place Date<br />
IF APPLICANT IS OR HAS BEEN MARRIED PARTICULARS OF HUSBAND/WIFE<br />
Single Married Widow/Widower Divorced<br />
Date of marriage Y Y Y Y M M D D<br />
Name (in full)............................................................................................. Maiden name of wife............................................................................................<br />
Identity No. ................................................................................................ Date of birth<br />
Place of birth ............................................................................................. Nationality ...................... .....................................................................................<br />
*I, .......................................................................................................................<br />
the best of my knowledge and belief correct.<br />
hereby declare that the information furnished above is to<br />
Signed .................................................................... Date ...................................................... Place..........................................................<br />
..........................................................................................................................................................................................................For Part II see overleaf
<strong>BI</strong>-<strong>63</strong><br />
PART II<br />
FOR COMPLETION BY RESPONSIBLE PARENT OR GUARDIAN ON BEHALF OF MINOR CHILD(REN)<br />
NB: The RESPONSIBLE PARENT is a parent as contemplated in Section 1 of the Guardianship Act, 1993 (Act No. 192 of 1993). Please indicate next to your signature below on what grounds you act as<br />
responsible parent. If divorced, documentary proof of custody and control of child/children is required.<br />
Particulars of children 1 2 3 4 5<br />
Surname<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
......................................................<br />
First names (in full)<br />
......................................................<br />
......................................................<br />
......................................................<br />
......................................................<br />
......................................................<br />
......................................................<br />
......................................................<br />
......................................................<br />
......................................................<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
Identity number<br />
Particulars of birth:<br />
......................................................<br />
Particulars of birth<br />
......................................................<br />
Particulars of birth<br />
......................................................<br />
Particulars of birth<br />
......................................................<br />
Particulars of birth<br />
......................................................<br />
Particulars of birth<br />
(a) Date<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
(b) Town<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
(c) Country<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
Nationality<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
Occupation<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
Present address<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
Date of entry<br />
Immigration Permit:<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
(a) Number<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
(b) Date of issue<br />
...................................................... ...................................................... ...................................................... ...................................................... ......................................................<br />
*I, ........................................................................................................................................................ declare that, to the best of my knowledge and belief the information furnished above, is correct.<br />
Signed ...............................................................................*(Father/Mother/Legal Guardian). Date .................................................................... Place ...............................................................................<br />
* Delete whichever is not applicable.
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