FORM 3
OUTCOME OF REQUEST AND OF FEES PAYABLE[Regulation 8]Note:
1. If your request is granted the—(a) amount of the deposit, (if any), is payable before your request is processed; and(b) requested record/portion of the record will only be released once proof of full payment isreceived.
2. Please use the reference number hereunder in all future correspondence.
Reference number: _______________________
TO:________________________________________________________________________________________________________________________Your request dated _____________, refers.
1.
You requested:
Personal inspection of information at registered address of public/private body (including
listening to recorded words, information which can be reproduced in sound, or information heldon computer or in an electronic or machine-readable form) is free of charge. You are required
to make an appointment for the inspection of the information and to bring this Form with you. If
you then require any form of reproduction of the information, you will be liable for the feesprescribed in Annexure B.
OR2.
You requested:
Printed copies of the information (including copies of any virtual images, transcriptions andinformation held on computer or in an electronic or machine-readable form )Written or printed transcription of virtual images (this includes photographs, slides, video
recordings, computer-generated images, sketches, etc)
Transcription of soundtrack (written or printed document)
Copy of information on flash drive (including virtual images and soundtracks)
Copy of information on compact disc drive(including virtual images and soundtracks)
Copy of record saved on cloud storage server
3.
To be submitted:
Postal services to postal address
Postal services to street address
Courier service to street address
Facsimile of information in written or printed format (including transcriptions)E-mail of information (including soundtracks if possible)
Cloud share/file transfer
Preferred language:(Note that if the record is not available in the language you prefer, access may be granted in
the language in which the record is available)
Kindly note that your request has been:
Approved
Denied, for the following reasons:

4.

Fees payable with regards to your request:
Item
Cost per A4-sizepage or part
thereof/item
Photocopy
Printed copy
For a copy in a computer-readable form on:(i)Flash drive
R40.00• To be provided by requestor(ii)
Compact discR40.00• If provided by requestor
R60.00• If provided to the requestor
For a transcription of visual images per A4-size
Service to be
pageoutsourced. Will
depend on theCopy of visual images
quotation of theservice provider
Transcription of an audio record, per A4-size
Copy of an audio record(i)Flash drive•
To be provided by requestor(ii)
Compact disc•
If provided by requestor•
If provided to the requestor
Postage, e-mail or any other electronictransfer:
TOTAL:

5.

Number ofpages/items

Total

R24.00

R40.00
R40.00
R60. 00
Actual costs

Deposit payable (if search exceeds six hours):
Yes

Hours ofsearchNo
Amount of deposit(calculated on one third of total amount perrequest)

The amount must be paid into the following Bank account:
Name of Bank:____________________________________Name of account holder:____________________________________
Type of account:____________________________________
Account number:____________________________________
Branch Code:____________________________________
Reference Nr:____________________________________
Submit proof of payment to:____________________________________

Signed at ____________________ this ___________ day of ________________ 20 ____________________________________________
Information officer