I.D.No.

650724 5712 08 6

GEREGISTREERDE WOON- EN POSADRES

I.DNN NANLMMEM
S.A.BURGER/S.A.CITIZEN

GEREGISTREERDE WOON- EN VANISURNAME

1Bewaar die bewys van u,
POSADRES in hieidie sakkie. MOKHELE
2 het, of indlen besonderhede van u
Indienu van adres vorandr
en/ofnonimer, ens. verandar hel, voORNAME/FORENAMES
inuidige adres, by.straalnaa ADRESVERANDERING, wat
nioet die vorm KENNISGEWING VAN word om die
ldenfiteitsdokunment is, getrulk
MANTIE MOSES
ln die
I1 ile sakKkiG aglor rd
verardernng meld en nioGl dit inngedlen
aan te woro oyOr gero9 VAN
distrikkantoor vui die DEPART EMENT
i ne nlaste streck GEBOORTEDISTRIK OF-LANDI
BINNELANDSE SAKE. BIRTH
COUNTRY OF
DISTRICT OR

SOUTH AFRICA
GEBOORTEDATUM 1965-07-24
DATE OF BIRTH
ADDRESS
AEGISTERED RESIDENTIAL AND POSTAL DATUM UITGEREIK
DATE ISSUED

RESIDENTIAL AND
1 Keep the proof of your REGISTERED 2003-02-07
POSTAL ADDAESS in this pockel.
UITOEReik o P OESAG VAN DIB

of TEUR-G BNERAAL
2. I you havechanged your address, or, il particulars your RRLAND SE AKE
e.9.name of Slreet and/orstreenumber, o10., have INNELA
present addiess, In the,
been changed, the NOTICE OF CHANGE OF ADDRESS toim
document must be used to report BY AUTHORITY
OF THE

Ockel at the back of the identity nearest

9sUED

in at or posted to the DIRECTOR-OENGRAL:

Ciango and it must bo tanded QOF HOME AFFAIRS. HOME APFAIRS

reglonal'disttict oflice Of the DERARTMENT

7ET A

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3 U I D - A F R I K A A N S E P O L I S I E D I E N S

c O M M U N I T Y S E R V I C E c E N T A E

SKRIF/

2022 -08- 0b
K O P A N U N G

SERVICE
P O L I C t

AFRICAN

OUTH