dw802

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DW802
DEPARTMENT OF WATER AFFAIRS AND FORESTRY
CHANGE OF
PARTICULARS
COMPANY, BUSINESS OR PARTNERSHIP;
NATIONAL OR PROVINCIAL GOVERNMENT
Official use only
1. CHANGES TO PARTICULARS OF COMPANY OR BUSINESS
1.1 a) Name of company, business or partnership
b) Trading name if different from name of company, business or partnership
1.2 a) Business registration number
b) date established
c) country where established
Y Y Y Y M M D D
1.3 Postal address of company or business
Postcode
1.4 Street address (only if different from postal address)
1.5 Contact telephone number during office hours
area/cell code
number
ext.
2. CHANGES TO PARTICULARS OF NATIONAL OR PROVINCIAL GOVERNMENT
2.1 National Department
2.2 a) Provincial Government
b) Provincial Department
3. CHANGES TO PARTICULARS OF PROPERTY OWNER (if not the applicant)
3.1 a) Surname of owner
b) initials
c) designation
d) ID number
3.2 Postal address
Postcode
3.3
Street address (only if different from postal address)
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3.4 Contact telephone number during office hours
area/cell code
number
ext.
4. REGISTRATIONS AND LICENCES TO WHICH THIS FORM REFERS
4.1 Register numbers for water use (attach a list if more than 16)
4.2 Licences for water use (attach a list if more than 16)
5. DECLARATION BY APPLICANT
5.1 a) Surname of delegated person
b) initials
c) designation (Ms, Mr, Miss, Mrs, Dr, Prof. etc.):
5.2 Position or official status
5.3 Postal address
Postcode
5.4 Contact telephone number during office hours
Area/cell code
number
ext.
5.5 I declare that the information given by me in applying for licensing is true and correct.
Signature
Date
Y Y Y Y
M M
D D
FOR OFFICIAL USE ONLY
File number
Received by:
Surname
Initials
Rank
Signature
Captured by:
Initials
Date stamp of receiving office
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