• Version
  • Download
  • File Size 174.41 KB
  • File Count
  • Create Date July 12, 2020
  • Last Updated July 12, 2020

National Heroes Dependents Assistance Regulations 1985 (Statutory Instrument 386 of 1985)

 

Statutory Instrument 386 of 1985.

National Heroes Dependents Assistance Regulations 1985

IT is hereby notified that the Minister of Labour, Manpower Planning and Social Welfare has, in terms of section 25 of the National Heroes’ Dependants Assistance Act, 1984, made the following regulations:—

  1. Title

These regulations may be cited as the National Heroes’ Dependants Assistance Regulations, 1985.

2.   Application for registration and for State assistance

An application for registration as a dependant of a national hero and for State assistance, in terms of section 12 of the Act, shall be made on the form set out in the Schedule.

SCHEDULE (Section 2)

FORM

APPLICATIONFOR REGISTRATION AND STATE ASSISTANCE BYA DEPENDANT OF A NATIONAL HERO IN TERMSOFSECTION 12 OFTHE NATIONAL HEROES’ DEPENDANTSASSISTANCE ACT, 1984

I ……………………….having been a dependant of……………………………………………………………….

a national hero (hereinafter called a hero) do hereby make application for registration as a dependant and for State assistance and my particulars are as below—

SECTION A

Personal particulars of applicant

  1. Surname …………………………………………………………………………………………………………
  2. First name(s) ……………………………………………………………………………………………..………
  3. National Registration number……………………………………………………………………………………
  4. Relationship to hero………………………………………………………………………………………………
  5. Citizenship…………………………………………………………………………………………………………
  6. Maiden name (in respect of widows) ……………………………………………………………………………
  7. Residential address ……………………………………………………………………………………………….
  8. Postal address …………………………………………………………………………………………………….
  9. State in         what     way      and       to         want     extent   you       were     dependant          upon     the        hero      and       for      how long……………………………………………………………………………………………………………………..

Particulars of hero’s children to be registered as dependants (children under eighteen years only)

Name Date of birth Place of birth
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………
………………………………. ………………………………………… ………………………………

Note—Marriage certificate, birth certificate and children’s birth certificates to be attached.

SECTION B

Particulars of assets and income

  1. Occupation………………………………………………………………………………………………………
  2. Name and address of present employer………………………………………………………………………….
  3. Salary per month $………………………………………………………………………………………………
  4. Are you in receipt of any pension benefit or award of any kind public

or private? Yes/No ………………………………………………………………………………………………

  1. If yes, please give details (like name of fund and amount of benefit)

………………………………………………………………………………………………………………..……… …………………………………………………………………………………………………………….………….

……………………………………………………………………………………………………………………..…

  1. If self-employed, state monthly earnings from self .employment $…………………………………………....
  2. What immovable property do you own? (house, farm, small holding, vacant stand, or other)…………………

………………………………………………………………………………………………………………………..

  1. If you are the owner—

(a)are you the occupier Yes/No……………………………………………………….…… (b)is any portion let Yes /No………………………………………………………..…..….

  1. Is the property mortgaged Yes/No………………………………………………………..…
  2. Amount of monthly bond repayment $………………………………………………………
  3. Which organization or individual granted the bond—

(a)Name…………………………………………………………………………………………………………

(b)Address………………………………………………………………………………………………………

  1. Who is now responsible for looking after you? ………………………………………………………................
  2. What is his/her relationship to the hero? ………………………………………………………………………..
  3. To what extent is he/she maintaining you? ………………………………………………………………………
  4. To what extent are you in need of support? ………………………………………………....................……..…

SECTION C

Specimen signature of applicant

Signature

The normal signature or right thumb print in the case of illiterate applicants is to appear in the space indicated.

SECTION D

(to be completed by applicant in the presence of a member of the Department of Social Welfare)

Declaration by applicant

I ………………………………………………………………………………………………….(full names)

hereby declare that the information given by me in this application is to the best of my knowledge and belief true and correct in every respect. I understand that any false statement on this form may render me liable to prosecution.

I also declare that this application has been read to me and fully explained in a language which I understand and that I have no further facts to add to my application.

I also understand that, while in receipt of State assistance, I must keep the Department of Social Welfare informed of any change of address and of any significant change in my financial circumstances.

Applicant’s signature

Mark or R.T.P.

Examiner’s signature

Date

Office held

THE REMAINING SECTIONS OF THIS FORM AREFOR OFFICIAL USE ONLY

SECTION E

  1. The underlisted documents have been checked:

Birth certificate

Marriage certificate

Children’s birth certificates

  1. I recommend/do not recommend payment of the following allowance

$ per month Widow         ………….. Children (per child)     …………..

Other dependants                                                                                               …………..

  1. Remarks:

Board members ……………………………………………..            Date ………………………..

……………………………………………..

……………………………………………..

……………………………………………..

……………………………………………..

……………………………………………..

……………………………………………..

Leave a Reply

Your email address will not be published. Required fields are marked *