PRIOR -rc o2oI7 CO PIRED I>Ca

PRIOR -rc o2oI7 CO PIRED I>Ca lel%n- 46 A Reakr vF POtAC---E -77024e-mJG CAFFLICATION FOR ACCESS TO SAPOL RECORDS) (FREEDOM OF INFORi ATIO:. ACT -SECTION 13i A FEE MUST ACCOMPANY THIS APPLICATION PROOF OF IDENTITY IS REQUIRED • Please use BLOCK letters • If you need help, ask our staff DETAILS OF PERSON A Pia yiNG FOR ACCESS TO SAPOL RECORDS Name: (mr, wr, mat M$ M'S PE-efk<Le -7\ '‘''iCC:t-t- Li O1€ C.911)sa- DOB ani taws tionstis) Residential Address: ___, Postcode. _ Telephone: (Home) (Work) (Mobile) Fax __ _. __ COMPLETE 1 HIS SECTION TO HAVE YOUR CORRESPONDENCE I: :IR =WED TO ANOTHER PERSON Company and contact name: _ .. . __. Company Actress: Postcode: Telephone: Fax: DETAILS OF REQUEST Please descaibe clearly what you want and include names of any other person(s) involved in incident, data, times, locations and any other information width VA help to identify the document(s). Your personal Involvement ill this requellt mg be included. • t