Annexure B

                            ANNEXURE "B"

 

 

(REGULATION 3 OF THE MEDIATION IN CERTAIN DIVORCE MATTERS REGULATIONS, 1990)

 

 

REQUEST TO FAMILY ADVOCATE TO INSTITUTE AN ENQUIRY IN TERMS OF SECTION 4 OF THE MEDIATION IN CERTAIN DIVORCE MATTERS ACT, 1987 (ACT NO 24 OF 1987)

 

 

1.       DETAILS OF APPLICANT REQUESTING ENQUIRY:

 

FULL NAME:                                                                     

 

RESIDENTIAL ADDRESS:                             

 

 

POSTAL ADDRESS:                                                

 

TELEPHONE NUMBERS:                                         (Home):   

 

(Work):  

 

Attorney: 

 

 

2.       IS APPLICANT A PARTY TO AN ACTION/APPLICATION INVOLVING MINOR OR DEPENDENT CHILDREN?

 

 

 

 

3.       WHERE WAS THE ACTION/APPLICATION INSTITUTED/LODGED?

 

 

 

4.       WHEN WAS THE ACTION/APPLICATION INSTITUTED/LODGED?

 

 

 

5.       COURT FILE REFERENCE NUMBER OF ACTION/APPLICATION:

 

 

 

 

 

 

 

6.       NAMES, AGES AND GENDER OF MINOR OR DEPENDENT CHILDREN INVOLVED IN ACTION/APPLICATION:

 

         

 

 

 

 

7.       DETAILS OF OTHER PARTY INVOLVED IN ACTION/APPLICATION:

 

FULL NAME:                                                                     

 

RESIDENTIAL ADDRESS:                             

 

POSTAL ADDRESS:                                                

 

 

 

TELEPHONE NUMBERS:                               (Work): 

 

                                                            (Sel): 

 

 

 

8.       FULL DETAILS OF REASONS WHY AN ENQUIRY IS REQUESTED:

 

 

 

 

9.       ARE YOU OR A MEMBER OF YOUR FAMILY KNOWN TO ANY WELFARE ORGANISATION OR AGENCY?  IF SO, STATE THE NAME OF THE ORGANISATION/AGENCY AND WHERE IT OPERATES

 

 

 

                                                                                            _________________________                                           

                                                                                                APPLICANT'S ATTORNEY

BOSTON LEGAL

1 Union Street

EMPANGENI

Statistic Form

 

CASE NO. .......................                                                                                  VORM 07-04

 

                                                                STATISTICS SOUTH AFRICA

 

                                                   STATISTICS OF DIVORCES

 

EXPLANATORY NOTES:

 

SECTIONS 1 - 4 TO BE COMPLETED FOR BOTH HUSBAND AND WIFE.

SECTIONS 5 – 10 TO BE COMPLETED BY THE PLAINTIFF.

 

1. IDENTITY	HUSBAND:	WIFE:
1.1        Name and Address of Plaintif
1.2        Population Group	1. White                                    2. Coloured 3. Indian/Asian 4. African/Black	1. White 2. Coloured 3. Indian/Asian 4. African/Black
1.3        Occupation at time of divorce
1.4        Plaintiff	1. Husband	2. Wife
2.          MARITAL STATUS AT TIME OF MARRIAGE	1. Never Married 2. Widower 3. Divorcee	1. Never married 2. Widow 3. Divorcee
3.          NUMBER OF TIMES MARRIED
4.          AGE AT TIME OF DIVORCE APPLICATION
5.          PRESENT MARRIAGE SOLEMNIZED	1. In Church	2. In Magistrate’s Office
6.          MATRIMONIAL PROPERTY SYSTEM	1. In Community of Property	2. Out of Community of Property
7.          NUMBER OF MINOR CHILDREN INVOLVED
8.          DATE OF MARRIEAGE	MONTH :	YEAR :
NB: SECTIONS 9 – 10 MUST BE COMPLETED BY THE REGISTRAR
9.          DATE OF DIVORCE	MONTH:	YEAR:
10.        HIGH COURT/              FAMILY COURT

Mark applicable block with a cross (X)

                                                                                                                                             

 

 

REGISTRAR: ………………….............................