1
2Annexure C
SUGGESTED FORMAT: PARENTAL CONSENT AFFIDAVIT
(CONSENT FOR PERSON UNDER THE AGE OF 18 TO TRAVEL TO OR FROM THE REPUBLIC)
I/We* hereby declare my/our consent that my/our daughter/son whose Unabridged Birth Certificate (UBC) or
**Equivalent document is attached may travel to and from South Africa:
Surname: ______________________ Name: ______________________ Date of birth _______________________
Identified by Passport no: _____________________ is travelling from ___________________________________ to
____________________ for the period _________________ to _____________________ 20_______________****
and / or** is a student / cared for at ________________________________________________________________
situated at (address) ____________________________________________________________________________
______________________. Contact number of learning institution/place of care: ____________________________
The child is accompanied / will be received in South Africa by (delete appropriately):
Surname, Name
Relationship
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Attach copy of South African ID or if a foreign national attach passport and visa of person receiving the child in SA.
Mother:
Surname, Name
Residential Address
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Signature and date
Attach copy of mother’s ID or passport.
Father:
Surname, Name
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Signature and date
Attach copy of father’s ID or passport.
Annexure C
SUGGESTED FORMAT: PARENTAL CONSENT AFFIDAVIT
(CONSENT FOR PERSON UNDER THE AGE OF 18 TO TRAVEL TO OR FROM THE REPUBLIC)
I/We* hereby declare my/our consent that my/our daughter/son whose Unabridged Birth Certificate (UBC) or
**Equivalent document is attached may travel to and from South Africa:
Surname: ______________________ Name: ______________________ Date of birth _______________________
Identified by Passport no: _____________________ is travelling from ___________________________________ to
____________________ for the period _________________ to _____________________ 20_______________****
and / or** is a student / cared for at ________________________________________________________________
situated at (address) ____________________________________________________________________________
______________________. Contact number of learning institution/place of care: ____________________________
The child is accompanied / will be received in South Africa by (delete appropriately):
Surname, Name
Relationship
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Attach copy of South African ID or if a foreign national attach passport and visa of person receiving the child in SA.
Mother:
Surname, Name
Residential Address
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Signature and date
Attach copy of mother’s ID or passport.
Father:
Surname, Name
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Signature and date
Attach copy of father’s ID or passport.
Annexure C
Legal Guardian:
Surname, Name
Residential Address
Work Address
Contact no. Work
Mobile
Residence
Signature
Date
Attach legal guardian’s appointment letter or court order and ID or passport.
Copies of the following documents are attached:
Unabridged Birth Certificate (UBC) or Equivalent Document of child travelling
ID or Passport and Visa of person receiving child in the Republic
Court Order (where applicable)
Death Certificate (of any deceased parent reflected on the UBC or Equivalent Document)
ID or Passport of parent(s) or legal guardian(s)
Thus signed and **sworn/solemnly affirmed before me on this …………. day of
… … … … … … … …..20… …… ….
… … … … … … … ……… ………… ……… ……… … ….
OFFICE STAMP
Commissioner of Oaths
(May be attested free of charge at any embassy or mission of the Republic of South Africa)
First name(s): … … … … … … … … … … … … … … …
Surname: … … … … … …… …… ………… ……… …
Capacity: …………………………………………….
Place: … … … … … … …… …… …… ……… …… … …
Contact Number: ……………………………………
*Both parents whose details appear on the UBC or Equivalent Document shall consent to the child’s travel.
Where only one parent’s details appear, only such parent’s consent is required.
**Delete whichever is not applicable.
***An Equivalent Document is any official document or letter issued by a foreign government (including a foreign embassy) or a
letter issued by the Director-General of the Department of Home Affairs in lieu of an unabridged birth certificate and which serves
as a confirmation of parentage of a person below the age of 18.
****This document remains valid only for the period stipulated.
