UNEMPLOYMENT INSURANCE ACT 63 OF 2001, AS AMENDED

NATIONAL LOCKDOWN
COVID19TERS
EMPLOYEE DECLARATION

Chamunorwa Alvera
I ________________________________________________________________, Identity Number E N 0 5 5 2 2 2
(Employee’s full name & surname)

Lawries Auto Electrical cc

Currently employed at ________________________________________________ 0175706/7
UIF Ref Number _______________________, hereby

16/08/2020
declare that I my employer temporarily laid me off for/during the period _________________________ 15/09/2020 because of the National Lockdown
to_________________________
and I will not report for duty as a measure to curb the spread of corona virus. I also declare that during this period my employer has not paid me my full remuneration/paid me
a portion of my remuneration*

The application for UIF benefits lodged is for the period stated above.

Details to be completed by Employer:

Applicant’s Details
Surname
Alvera
First Names
Chamunorwa
Identity number / Passport
EN055222
Commencement date
01/03/2010
Date last worked
26/03/2020
Remuneration ( PW/PM)
R13310.57
Income earned during lock down
0.000

Company Details
UIF reference number
0175706/7
Name of Company
Lawries Auto Electrical cc
Physical Address
319E Mgwaza Maphalala street Durban 4001
Contact details
• Office: 031-2060378
• Cell :
0781488447

Employees banking details if available

Name of account
Stanndard Bank
Type of account
Account type
Elite current acc
Account Number
200699210
Durban
Signed at: ___________________________________on the ___________________________

_______________________________________________ COMPANY STAMP (if available)

EMPLOYEE’S SIGNATURE

___________________________________________________
EMPLOYER SIGNATURE/ EMPLOYER REPRESENTATIVE