PAIA — Form 02

Request a record

This fills in the prescribed form for you. Nothing leaves your browser until you press send — we do not receive or store anything you type here. The manual explains what we hold.

About youFull names and surname *Identity numberPostal address *Contact number *Email address *If you are asking on someone else’s behalf, in what capacity?Leave blank if the request is for yourself. Proof of capacity must be attached.Full names of the person the request is forOnly if you are not asking for yourself.

What you wantDescribe the record *Be specific enough that we can find it. “My booking history and the messages on booking #1234” beats “everything you have”.

Reference number, if knownPeriod it covers

How you want it

A printed copyAn electronic copy (email)To inspect the record in personA transcript or written version of a recording

How we should tell you the outcome

EmailPhone callPost

If a disability means you need it in a particular format, say which

Why you need it

PAIA lets a private body release a record only where you say which right you are exercising or protecting, and why this record is needed for it. Without this we are obliged to refuse, so it is worth a sentence or two.

The right you are exercising or protecting *Why the record is required for it *

Your completed request

Still needed: Full names and surname, Postal address, Contact number, Email address, Description of the record, The right you are exercising or protecting, Why the record is required.

REQUEST FOR ACCESS TO RECORD OF A PRIVATE BODY
(Form 02, Regulation 7 — Promotion of Access to Information Act 2 of 2000)

PART A — THE PRIVATE BODY
[Registered company name] (Pty) Ltd
Registration number: [Company registration number]
[Street address], Johannesburg, Gauteng, South Africa
For attention: [Full name], Information Officer (privacy@blazeverse.co.za)

PART B — THE REQUESTER
Full names and surname: —
Identity number: —
Postal address: —
Contact number: —
Email address: —
If you are asking on someone else’s behalf, in what capacity?: —
Full names of the person the request is for: —

PART C — THE RECORD REQUESTED
—
Reference number, if known: —
Period the record covers: —

PART D — FORM OF ACCESS
An electronic copy (email)
Notify me of the decision by: Email
Disability requiring a particular format: None

PART E — RIGHT TO BE EXERCISED OR PROTECTED (section 50(1)(a))
—

Why the record is required in order to exercise or protect that right:
—

I confirm the information above is true and correct.

Signed: ______________________   Date: ______________

Email it to us

We must decide within 30 days. If a fee applies we will tell you the amount first, and you can withdraw the request rather than pay it.