home affairs

Department:
Home Affairs
REPUBLIC OF SOUTH AFRICA

SUGGESTED FORMAT: PARENTAL CONSENT LETTER

(CoNSENT FOR PERSON UNDER THE AGE OF 18 TO TRAVEL TO OR FRoM THE REPUBLIC)

HWe* hereby declare mylour consent that msour daughterlsen whose Birth Certificate (BC) is attached may travel to
and from South Africa:

Surname: NGUBANE Name: NONHLE LUYANDA Date of birth 2012-04-18

Identified by Passport no: 1204181321081 is travelling from SOUTH AFRICA
uNtTEp KTNGDOM for the period 1sT AUGUST 2,023 to 31ST JANUARY
anrl fern* is a student / eared{er atLAEREI(OOL BIRCHLEIGH
situated at (address) 177 OLIENHOUTLAAN, BIRCHLEIGH, KEMPTONPARF 9fyJEf'l.G=
Contact number of learning institutionlplace of care: 1-972 2127
United Kingdom
The child is willbe received in SeuthAfriea delete
Surname, Name NCUBE MINENHLE GLADYS
Relationship MOTHER
Residential Address 174 MARTINS LANE. BLAKEHALL. SKELIVIERSDALE.
LANCASHIRE, WN8 gAY, ENGI-AND, UK
Work Address AKARI CARE LTD.4TH FLOOR, ALBION STREET, LEED€-ISJ
6AG
Contact No: Work 0113 468 800 Mobile +44 777O 628083 Residence
copy it S;outh African lD or if a fareign
ettacn cooi
Nlacn passporl and visa of person receiving the child in
foreiqn national attach passport

Mother:
Surname, Name NCUBE MINENHLE GLADYS
Residential Address 174 MARTINS LANE. BLAKEHALL, SKELMERSDALE.
LANCASHIRE, WN8 gAY, ENGLAND, UK
Residential Address

Work Address AKARI CARE LTD,4TH FLOOR, ALBION STREET.LEEDS, LS1

6AG
Contact No: Work Mobile +44 7770 628083 Residence
Siqnature and date
Attach copy of mother's lD or passport.

Father:
Surname, Name WONDERBOY NGUBANE
Residential Address 602 PLETTENBERG HSE, 130 BANKET STREET, HILLBRO}V,
JOHANNESBURG,GAUTENG, 21 98
Work Address POPPY'S RESTAURANT.CNR. JUDGES & BEYERS NAUDE DR,
CRESTA, RANDBU RG,GAUTENG
Contact No: Work 084 640 0400 Mobile 060 387 7032 Residence
Siqnature and date #t**€*-" 2_\ 1,3t, ! Zp'.L4
Attach copy of fatheds lD or passport.
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Attach legal guardian's appointment letter or court order and lD or passport.

Copies of the following documents are attached:

w Birth Certificate (BC) of child travelling

d lD or Passport and Visa of person receiving child in the Republie UNrED KINGDoM

rMx Court Order (where applicable)

ffi
fr
Death Certificate (of any deceased parent reflected on the BC

lD or Passport of parent(s) or legal guardian(s)

*Both parents whose details appear on the BC shall consent lo the child's trave!.
Vihere only one parent's details appear, only such parent's consent is required.

**Delete
whichever is not applicable.

***Ihls docum ent remains valld only for the period stipulated, which may not exceed sx (6) monfhs.
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IVIARI YEKUNE DZIMWE NYIKA YOKUFAMBISA
IIVIAL' YOKUHAMBISA EYAMANYE AMAZWE, - -
TONEiCI'I TiCHATAT FOR TRAVELLING EXPENSES

&unyora Bapeii rino tutrze hil;m3fflargi omuZlmltbrc

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