74   No. 41970 GOVERNMENT GAZETTE, 12 OCTOBER 2018 DHA-14A REPUBLIC OF SOUTH AFRICA DEPARTMENT OF HOME AFFAIRS Barcode Annexure 9 BURIAL ORDER [Births and Deaths Registration Act 51 of 1992] The form to be completed in BLACK INK with BLOCK LETTERS. Please mark with R the CORRECT box, where required by the Home Affairs Official Date of Issue Y Y Y Y M M D D Serial number of DHA-1663 Bar-code number of DHA-1663 A. PARTICULARS OF DECEASED Identity number Passport number (if foreigner) Date of birth Y Y Y Y M M D D Date of death Y Y Y Y M M D D Citizenship Sex Surname Previous or Maiden surname Forenames Place of death: City/Town Province Place of burial : City/Town Cause of death Province Natural Unnatural Under investigation B. AUTHORITY FOR BURIAL OF CORPSE This certificate grants the authority for the burial of the corpse from the magisterial district in which the death occurred or at the magisterial district where the burial will take place. C. FOR OFFICIAL USE ONLY Registration of death approved and burial order issued. DHA-1663 received by (particulars of DHA official): Surname DHA Office stamp Forenames Persal No. Documents included with this notice: Copy of the deceased's ID/ passort Copy of ID document/ passport of the informant DHA-1663 was submitted by: Informant Funeral Undertaker Identity Number of Recepeint: Identity number If Funeral Undertaker: Designation number Signature of recipient Date received Y Y This gazette is also available free online at www.gpwonline.co.za Y Y M M D D