52 No. 41970
GOVERNMENT GAZETTE, 12 OCTOBER 2018
LEFT RING
FINGERPRINTS FOR THE NOTICE OF BIRTH
DO NOT PHOTO COPY
PLEASE NOTE: Fingerprints may only be taken by an official of the Department of Home
Affairs. Should a finger be missing, deformed or so injured that the impression cannot be
taken, this fact should be noted in the space provided for that impression.
LEFT MIDDLE
FINGERPRINTS OF:
Please tick appropriate box
PERSONAL PARTICULARS
CHILD/ ADULT
INFORMANT
CHILD
Surname: ___________________________________________________
Forenames: _________________________________________________
Date of Birth
(YYYY/MM/DD)
RIGHT MIDDLE
No photo required for
Informant
No photo is required
where child is younger
than 7 years
DHA-24/A
RIGHT RING
PHOTO
LEFT INDEX
INFORMANT
Surname: ___________________________________________________
Forenames: _________________________________________________
Identity No./
Passport No.
FINGERPRINTS TAKEN BY: PLEASE PRINT FULL NAME
RIGHT INDEX
LEFT MALL
Photo of the CHILD only
RIGHT SMALL
Annexure 1B
PERSAL NUMBER
RETURN THE FORM TO: _____________________________
Name of Regional Office (or head office: population register, if foreign birth)
REGISTERING FINGERS
NO. 1
-
NO 2
Departmental office stamp – Office of origin
LEFT THUMB
RIGHT THUMB
This gazette is also available free online at www.gpwonline.co.za
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LEFT THUMB
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