FORM 2: REQUEST FOR ACCESS TO RECORD

[Regulation 7]

NOTE:

1. Proof of identity must be attached by the requester.

2. If a request is made on behalf of another person, proof of such authorisation must be attached.

A. PARTICULARS OF THE BODY

To the Information Officer of:

• Name of Public/Private Body: [Insert Company or Government Department Name]

• Postal Address: [Insert Address]

• Email Address: [Insert Email]

• Fax Number: [Insert Fax if applicable]

B. PARTICULARS OF THE REQUESTER (Person requesting access)

• Full Names and Surname: [Your Name and Surname]

• Identity Number: [Your SA ID Number]

• Postal Address: [Your Postal Address]

• Street Address: [Your Residential/Business Address]

• Telephone Number: [Your Phone Number]

• Email Address: [Your Email Address]

• Capacity in which request is made (when made on behalf of another person): [e.g., Self / Legal Representative / Director]

C. PARTICULARS OF PERSON ON WHOSE BEHALF REQUEST IS MADE

(This section must be completed ONLY if a request for information is made on behalf of another person)

• Full Names and Surname: [Name of person you are representing]

• Identity Number: [Their SA ID Number]

D. PARTICULARS OF RECORD REQUESTED

Provide full particulars of the record to which access is requested, including the reference number if that is known to you, to enable the record to be located.

1. Description of record or relevant part of the record:

   [Clearly describe what documents you want, e.g., "My employment contract from 2022," or "All billing statements for account number 12345"]

2. Reference number, if available: [Insert reference/account/case number]

3. Any further particulars of record: [Any extra context to help them find it]

E. TYPE OF RECORD

Mark the appropriate box with an X.

• [ ] Written or printed record

• [ ] Visual images (photographs, video recordings, computer-generated images, sketches, etc.)

• [ ] Recorded words or information which can be reproduced in sound

• [ ] Held on a computer or in an electronic or automated form

F. FORM OF ACCESS

Mark the appropriate box with an X.

• [ ] Printed copy of record (including transcriptions)

• [ ] Inspection of the record

• [ ] Copy of the record on flash drive (USB)

• [ ] Copy of the record on compact disc drive (CD/DVD)

• [ ] Electronic copy via email/cloud transfer

G. PARTICULARS OF RIGHT TO BE EXERCISED OR PROTECTED

(If the space provided is inadequate, please continue on a separate page and attach it to this form).

1. Indicate which right is to be exercised or protected:

   [e.g., "The right to constitutional equality," or "The right to a fair labor practice/protection of personal financial data."]

2. Explain why the record requested is required for the exercise or protection of the aforementioned right:

   [e.g., "The requested record is required to verify accurate financial transactions and protect against unauthorized identity theft."]

H. NOTICE OF DECISION REGARDING REQUEST FOR ACCESS

You will be notified in writing whether your request has been approved or denied. Please specify how you wish to be informed:

• [ ] Postal Address

• [ ] Email

• [ ] Fax

Signed at ___________________________ this ________ day of ___________________ 20___

Signature of Requester / Person on whose behalf request is made