Bl-31

DECLARATION FOR THE PURPOSE OF A MARRIAGE

[Section 12 (b) of the Marriage Act, 19611
Note: (a) Marriage officers should note that section 12 (a) of the Marriage Act provides that if an identity document has been issued
to a prospective husband/wife such identity document must be requested by the marriage officer for perusal.
(b) This declaration must therefore only be completed by a prospective husband/wife who is not in possession of an
identity document referred to in the Identification Act, 1997.
(c) PRINT CLEARLY USING BLACK INK.

A. Particuiars of appIicant:
1. Surname . . . . . . ~..,.... . . ..‘.............~........~................................~........................................~...............................”...............~......“.~.~.
2. Maiden name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~.....~..........~.~...~........~~~...........~...~..~........~.~.~........~~.....~..~...~.........................~.....~~....~..~.~~.~.
3. Forenames in full. . . . ..“......................~.............~....................................~.........................~..................~.....................“”......‘...“...
4. Date of birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~..~....... 5. Country of birth . . . . . . . . . . . . . . . . . . . . . ~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..“.“........
6. Marital status (e.g. bachelor, spinster, widower, widow or divorcee, as the case may be) . . . . . . ~. . . . . . . . ~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~. . . . . . . . . . ~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..............~.......................................
8. Permanent residential address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~.~.~........................ ~. . . . . . . . . ~. . ..“............“... ~.
9. If not a South African citizen, residential status in Republic (quote lmmigrat~~n Permit or Temporary Residence Permit No.
and date of issue) . ..~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~...~.............................................. ~. . . . . . . . . . . . . . . . . . ..~................~..
NB: An alien who is illegally in the country or who is a prohibited person or who resides temporarily in the Republic,
must please note that he or she will not acquire a right to permanent residence in the Republic merely as a result
of his or her marriage to a South African citizen or a permanent resident-see section 25 of the Aliens Control
Act, 1991~

B. Particulars of prospective *husband/wife:

10. Surname...~.. . . . . . . . . . . . . . . . . . ..~..................~........~.~.....~......~...~...~........~~....~~...~...............~...~.~.....~..~......~~..........~~...........~...~......~....
11. Maiden name . . . . . . . . . . . . . . . . * . . ..~.....~.....~.......~.........~......~.............‘.................................~.~..”............................~.....“..............~.....
12. Forenames in full. . . . . . . . . . ..~.~.................*...~.~............*.*..........~...~..............~...................~...............................~............“~.......~.....
13. Date of birth . . . . . . . . . . . . . . . .~ . . . . . . . . . . . . . . . . . . . . . . . . ..~.~.~.*................~..................................”.....................~~....“........~.........~..........*“.........
I *declare under oath/solemnly declare that the particulars given above are to the best of my knowledge and belief true
and correct and that there is no lawful impediment to our prospective marriage.

. . . . . . . . . . . . . . . . . . . . . . . . . ..*..............................*...........*..... . . . . . . . . . . . . . ..*......................*.....................................
Date Sig-ia ture
* Delete whichever is not applicable.

CL Dec!aratkm:

I certify that before administering the prescribed oath/solemn declaration I asked the deponent the following questions and
wrote down his/her answer in his/her presence:
(1) Do you know and understand the contents of the above declaration?

Answer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..““............ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~. . . . . . . . . . . . . . . . . . . . . . . . . . ..~...~...................~.......~.........

(2) Do you have any objection to taking the prescribed oath?
Ans wet-. . . . . . . . . ..~.‘............~......“........”...~.”.......~......................“.~.........~.~....~......~.........~.......~...~...........“..“...~....~~...........~..
(3) Do you consider the prescribed oath/solemn declaration to be binding on your conscience?
Answer.. . . . . . . . . . . . . . . . . . . . ..“.........~..........................................~.........~.........................‘............“........~...........‘....~....‘...“..........
I certify that the deponent has acknowledged, that he/she knows and understands the contents of the above
declaration which was sworn to/affirmed before me and that the deponent’s signature/thumb print/mark was placed
thereon in my presence.
I also certify that the contents of paragraph 9 were properly explained to the deponent who acknowledged that he or she
understands the implications thereof.

Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~....................,.............
Commissioner of Oaths

Forename(s} and surname . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~...............................................................................

Address.. . . . . . . . . . . . . . . . . . . . . . . . . ..~...........................................................~.......~..................~.......~......~‘.~...‘~..~......~........................~...

Designation (Rank) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~.................................. Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .