The South African Constitution entrenches the fundamental right to access of information. A statutory right is provided for, to access on request to records held by the state as well as access to records held by private bodies.

The Promotion of Access to Information Act 2 of 2000 (“PAIA”), which came into effect on 9 March 2001, seeks to advance the values of transparency and accountability in South Africa and provides the mechanism for requesters to exercise and protect their constitutional right to request access to a record.

The Act establishes the following statutory rights of requesters to any record of a private body if:

• That record is required for the exercise or protection of any of his or her legal rights;

• That requester complies with all the procedural requirements; and

• Access is not refused in terms of any ground referred to in the Act.

In terms of the Act private bodies are required to publish a manual to assist requesters who wish to request access to a record.

This PAIA manual is based on the template provide by the Information Regulator at the end of 2021.

2. INTRODUCTION TO THE PRACTICE

Mrs. CLAIRE KOURIE practices as Claire Kourie Physiotherapists Inc 2019/438984/21 at Suite C25, Life Healthcare, Cedar Rd, Fourways, Johannesburg, Gauteng, 2055.

For disclosure purposes, Mrs. CLAIRE KOURIE has no interests in other legal entities.

3. LIST OF ACRONYMS AND ABBREVIATIONS AND RESPECTIVE MEANINGS

Word/ acronym	Meaning
Guide	Guide on how to use PAIA issued by the Information Regulator (in terms of section 10(1) of PAIA)
Minister	Minister of Justice and Correctional Services
PAIA	Promotion of Access to Information Act No. 2 of 2000 (as amended)
PAIA Manual	This manual prepared in terms of section 51 of the Promotion of Access to Information Act No. 2 of 2000 (as amended)
Personal Information	a. information relating to the race, gender, sex, pregnancy, marital status, national, ethnic or social origin, colour, sexual orientation, age, physical or mental health, well-being, disability, religion, conscience, belief, culture, language and birth of the person; b. information relating to the education or the medical, financial, criminal or employment history of the person; c. any identifying number, symbol, e-mail address, physical address, telephone number, location information, online identifier or other particular assignment to the person; d. the biometric information of the person; e. the personal opinions, views or preferences of the person; f. correspondence sent by the person that is implicitly or explicitly of a private or confidential nature or further correspondence that would reveal the contents of the original correspondence; g. the views or opinions of another individual about the person; and h. the name of the person if it appears with other personal information relating to the person or if the disclosure of the name itself would reveal information about the person.
POPIA	Protection of Personal Information Act No. 4 of 2013
POPIA Regulations	The regulations promulgated in terms of section 112(2) of POPIA
Private body	a. a natural person who carries or has carried on any trade, business or profession, but only in such capacity; b. a partnership which carries or has carried on any trade, business or profession; orc. c. any former or existing juristic person, but excludes a public body.
Processing	a. Any operation or activity or any set of operations, whether or not by automatic means, concerning personal information, including b. the collection, receipt, recording, organisation, collation, storage, updating or modification, retrieval, alteration, consultation or use; c. dissemination by means of transmission, distribution or making available in any other form; ord. d. merging, linking, as well as restriction, degradation, erasure or destruction of information.
Regulator	Information Regulator
Republic	Republic of South Africa
The Practice	Mrs CLAIRE KOURIE, Physiotherapist Address/es: Suite C25 Life Healthcare, Cedar Rd Fourways, Johannesburg Gauteng 2055

4. PURPOSE OF PAIA MANUAL

This PAIA Manual is useful for the public to-

check the categories of records held by a body which are available without a person having to submit a formal PAIA request;
- have a sufficient understanding of how to make a request for access to a record of the body, by providing a description of the subjects on which the body holds records and the categories of records held on each subject;
- know the description of the records of the body which are available in accordance with any other legislation;
- access all the relevant contact details of the Information Officer who will assist the public with the records they intend to access;
- know the description of the guide on how to use PAIA, as updated by the Regulator and how to obtain access to it;
- know if the body will process personal information, the purpose of processing of personal information and the description of the categories of data subjects and of the information or categories of information relating thereto;
- know the description of the categories of data subjects and of the information or categories of information relating thereto;
- know the recipients or categories of recipients to whom the personal information may be supplied;
- know if the body has planned to transfer or process personal information outside the Republic of South Africa and the recipients or categories of recipients to whom the personal information may be supplied; and
- know whether the body has appropriate security measures to ensure the confidentiality, integrity and availability of the personal information which is to be processed.

5. KEY CONTACT DETAILS FOR ACCESS TO INFORMATION

Address/es:
Suite C25,
Life Healthcare,
Cedar Rd,
Fourways,
Johannesburg, Gauteng, 2055

Information Officer:
Name: CLAIRE KOURIE
Tel: 0722126907
Email: clairekourie@gmail.com

Access to information general contacts:
E-mail: info@physioforlife.co.za
Address/es: Suite C25,
Life Healthcare,
Cedar Rd,
Fourways,
Johannesburg,
Gauteng,
2055

6. GUIDE ON HOW TO USE PAIA AND HOW TO OBTAIN ACCESS TO THE GUIDE

The Regulator has, in terms of section 10(1) of PAIA, as amended, updated and made available the revised Guide on how to use PAIA (“Guide”), in an easily comprehensible form and manner, as may reasonably be required by a person who wishes to exercise any right contemplated in PAIA and POPIA.
- The Guide is available in each of the official languages and in braille.
- The Guide contains the description of-
  - the objects of PAIA and POPIA;
    - the postal and street address, phone and fax number and, if available, electronic mail address of the Information Officer of every public body, and
  - every Deputy Information Officer of every public and private body designated in terms of section 17(1) of PAIA[1] and section 56 of POPIA[2];
the manner and form of a request for-
- access to a record of a public body contemplated in section 11[3]; and
- access to a record of a private body contemplated in section 50[4];
- the assistance available from the Information Officer of a public body in terms of PAIA and POPIA;
- the assistance available from the Regulator in terms of PAIA and POPIA;
- all remedies in law available regarding an act or failure to act in respect of a right or duty conferred or imposed by PAIA and POPIA, including the manner of lodging-
  - an internal appeal;
  - a complaint to the Regulator; and
  - an application with a court against a decision by the information officer of a public body, a decision on internal appeal or a decision by the Regulator or a decision of the head of a private body;
  - the provisions of sections 14[5] and 51[6] requiring a public body and private body, respectively, to compile a manual, and how to obtain access to a manual;
  - the provisions of sections 15[7] and 52[8] providing for the voluntary disclosure of categories of records by a public body and private body, respectively;
  - the notices issued in terms of sections 22[9] and 54[10] regarding fees to be paid in relation to requests for access; and
  - the regulations made in terms of section 92[11].

• Members of the public can inspect or make copies of the Guide from the offices of the public and private bodies, including the office of the Regulator, during normal working hours.

• The Guide can also be obtained-

from the website of the Regulator (https://inforegulator.org.za/).
upon request by completing and submitting Form 1 Request for a copy of the guide (Refer Annexure 1) to the Information Officer.

• A copy of the Guide is also available at the Practice in English and Afrikaans languages for public inspection during normal office hours.

7. ACCESS TO RECORDS OF THIRD PARTIES HELD BY THE PRACTICE

7.1 The request procedure

The requester must use Form 2 Request for access to record (Refer Annexure 2), to make the request for access to a record. The request must be directed to the Information Officer, whose contact details are set out in 5 above.
The prescribed form must be submitted as well as payment of the request fee and a deposit (Refer Annexure 3), if applicable to the Information Officer at the postal address, physical address or electronic mail as is stated herein.
The prescribed form must be completed with enough particularity to enable the information officer to determine:
The record(s) requested;
The identity of the requestor;
What form of access is required; and
The Postal address or fax number of the requestor.
- The requestor must state that the records are required for the requestor to exercise or protect a right and clearly state what the nature of the right is so to be exercised or protected. An explanation of why the records requested to exercise or protect the right, is required.
- The request for access will be dealt with within 30 days from date of receipt, unless the requestor has set out special grounds that satisfies the Information Officer that the request be dealt with sooner.
- The period of 30 days may be extended by not more than 30 additional days, if the request is for a large quantity of information, or the request requires a search for information held at another office of the Company and the information cannot be reasonably obtained within 30 days. The Information Officer will notify the requestor in writing should an extension be necessary.
- The requestor will be informed in writing (by using Form 3 Outcome of request and of fees payable – Annexure 4) whether access to the records have been granted or denied. If the requestor requires a reason for the decision, the request must be expressed in the prescribed form; the requestor must be further state what particulars of the reasoning the requestor requires.
- If a requestor has requested the records on another individual’s behalf, the requestor must submit proof of the capacity the requestor submits the request in, to the satisfaction of the Information Officer.
- Should the requestor have any difficulty with the form or the process laid out herein, the requestor should contact the Information Officer for assistance.
- An oral request can be made to the Information Officer should the requestor be unable to complete the form due to illiteracy or a disability. The Information Officer will complete the form on behalf of the requestor and provide a copy of the form to the requestor.

7.2 Grounds for refusal of access to records

The Information Officer shall, subject to other provisions of PAIA, refuse a request for information or record if that information or record relates to:

Mandatory protection of the privacy of a third party who is a natural person, which involves the unreasonable disclosure of Personal Information of that natural person;
- Mandatory protection of the commercial information of a third party, if the record contains:
  - Trade secrets of that third party;
  - Financial, commercial, scientific or technical information which the disclosure could likely cause harm to the financial or commercial interests of that third party;
  - Information supplied in confidence by a third party to The Practice/s, if the disclosure could put that third party at a disadvantage in negotiations or commercial competition.
- Mandatory protection of confidential information of third parties if it is protected in terms of any agreement;
- Mandatory protection of the safety of individuals and the protection of property;
- Mandatory protection of records which would be regarded as privileged in legal proceedings;
- The information about research being or to be carried out by or on behalf of a third party where disclosure would likely expose that third party or the person that is or will be carrying on the research on behalf of that third party or the subject matter of the research to serious disadvantage.
- The Information Officer may refuse a request for information or record if that information or record relates to:
  - information that was supplied by a third party, in confidence, the disclosure of which could reasonably be expected to prejudice the future supply of similar information, or information from the same source and it is in the public interest that such information, or information from the same source should continue to be supplied;
  - mandatory protection of safety of individuals and protection of property;
  - mandatory protection of law enforcement and legal proceedings;
  - the commercial activities of The Practice/s, which may include:
    - Trade secrets of The Practice/s;
    - financial, commercial, scientific or technical information which disclosure could likely cause harm to the financial or commercial interests of The Practice/s;
    - information which, if disclosed could put The Practice/s at a disadvantage in negotiations or commercial competition;
    - a computer program which is owned by The Practice/s and which is protected by copyright.
  - information about research being or to be carried out by or on behalf of The Practice/s, the disclosure of which would likely to expose The Practice/s or the person that is or will be carrying out the research on behalf of The Practice/s or the subject matter of the research, to serious disadvantage.
  - an opinion, advice, report or recommendation obtained or prepared, or an account of a consultation, discussion or deliberation that has occurred, including but not limited to, minutes of a meeting, for the purpose of assisting to formulate a policy or to take a decision in the exercise of a power or performance of a duty conferred or imposed by law.
  - requests that are frivolous or vexatious or involve an unreasonable diversion of The Practice/s resources.

7.3 Remedies should a request be refused

• Decisions made by the Information Officer is final.

• The requestor may in accordance with sections 56(3) (c) and 78 of PAIA, apply to a court for relief within 180 days of notification of the decision for appropriate relief.

8. CATEGORIES OF RECORDS OF THE PRACTICE/S WHICH ARE AVAILABLE WITH OUT A PERSON HAVING TO REQUEST ACCESS

Records of a public nature may be accessed without having to make a request. This includes the contact details of the practice, available at Suite C25, Life Healthcare, Cedar Rd, Fourways, Johannesburg, Gauteng, 2055, and product brochures/ pamphlets.

9. DESCRIPTION OF THE RECORDS OF THE PRACTICE/S WHICH ARE AVAILABLE IN ACCORDANCE WITH ANY OTHER LEGISLATION

Category of Records	Applicable Legislation
PAIA Manual	PAIA POPIA
HR documents in line with legislation	Basic Conditions of Employment Act, 75 of 1997 Employment Equity Act, 55 of 1998 Labour Relations Act, 66 of 1995

The Practice process information as required by South African legislation (such as listed below). Where required in terms of the relevant legislation, documents referred to in terms of the legislation may be requested by using the access procedure provided for in paragraph 7 Access to records of third parties.

The Practice/s are required to hold certain records in terms of legislation, including:

1. Basic Conditions of Employment Act 75 of 1997;

2. Broad-based Black Economic Empowerment Act 53 of 2003;

3. Children’s Act 38 of 2005;

4. Choice on Termination of Pregnancy Act 92 of 1996;

5. Companies Act 71 of 2008;

6. Compensation for Occupational Injuries and Diseases Act 130 of 1993;

7. Consumer Protection Act 68 of 2008;

8. Electronic Communications Act 36 of 2005;

9. Electronic Communications and Transactions Act 25 of 2002;

10. Employment Equity Act 55 of 1998;

11. Income Tax Act 58 of 1962;

12. Labour Relations Act 66 of 1995;

13. National Credit Act 34 of 2005;

14. National Health Act 61 of 2003;

15. Occupational Health and Safety Act 85 of 1993;

16. Pension Funds Act 24 of 1956;

17. Promotion of Access to Information Act 2 of 2000;

18. Protection of Personal Information Act 4 of 2013;

19. Road Accident Fund Act 56 of 1996.

20. Skills Development Act 97 of 1998;

21. Skills Development Levies Act 9 of 1999;

22. Telecommunications Act 103 of 1996;

23. Unemployment Contributions Act 4 of 2002;

24. Unemployment Insurance Act 63 of 2001;

25. Value Added Tax Act 89 of 1991.

10. DESCRIPTION OF SUBJECTS ON WHICH THE PRACTICE/S HOLD RECORDS AND CATEGORIES OF RECORDS HELD ON EACH SUBJECT BY THE PRACTICE/S

Subjects on which records are held, include:	Categories of records, include
Records relating to the professional status of persons working for The Practice	Certificates and cards proving professional registration as medical practitioners, and other relevant statutory Boards and Councils; proof of payment of annual and registration fees; certificates of good standing.
Records related to assets, financial records	Annual financial statements, auditor’s reports, accounting records, bank statements, stock sheets, delivery notes, orders, invoices, statements, and receipts.
Records related to patients	Name, surname telephone numbers, bank account details, account holder, medical fund details, contact number(s), ID Number, physical/ postal address and all other contact details etc.
Pension and retirement fund records	Pension fund rules, account records.
Employment Equity	Details of senior manager responsible for Employment Equity, reports (EEA2, EEA4, EEA12 & EEA13), Minutes of meetings.
Agreements	Agreements such as employee agreements, licence agreements, non-disclosure agreements, use agreements, joint venture agreements, IT agreements (software and hardware), agreements concerning provision of services or materials, agreements with contractors and suppliers, sale agreements, purchase agreements, lease agreements.
Tax and VAT records	Copies of all tax returns and documents relating to income tax and VAT, including payments made.
Insurance records	Insurance policies, professional indemnity insurance, details of insurance coverage, limits and insurers.

11. DESCRIPTION OF PROCESSING OF PERSONAL INFORMATION

11.1 Purpose of Processing Personal Information

Patient information for reasons such as diagnostic and payments.

Human Resources data is collected for reasons including for HR and statutory reporting, payroll, communicating with employees and to use in the case of emergencies. It is also used for employee benefits purposes to provide medical aid cover and for retirement benefits.

11.2 Description of the categories of Data Subjects and of the information or categories of information relating thereto, including:

Data Subject Types	Categories of information/ information relating to data subjects
Employees	• Onboarding and exit process • Process payments to employees
Suppliers	Onboarding and payment for services rendered
Prospects	Potential employment
Patients	Names, surnames, address, telephone number, bank account details, account holder, medical fund details, contact number(s), ID Number, place of residence address and all other contact details etc.

11.3 The recipients or categories of recipients to whom the personal information may be supplied, includes:

Category of personal information	Recipients or categories of recipients to whom the personal information may be supplied
Patient information	Patients, medical aids, medical practitioners, hospitals
HR Data	Auditors, Department of Labour, CCMA, training service providers

12. PLANNED TRANS BORDER FLOWS OF PERSONAL INFORMATION

The Practice/s are not planning to send any personal information about any data subject across the borders of the Republic of South Africa to third parties in foreign countries. Should this be required consent will have to be obtained, where possible, and transfers will be in accordance with the requirements of the law.

13. SECURITY MEASURES TO PROTECT PERSONAL INFORMATION

The Practice implements appropriate technical, physical, and organisational security measures to protect personal information against loss, misuse, unauthorised access, disclosure, alteration, or destruction. Personal information is only accessible to authorised persons who require access for legitimate healthcare, administrative, or legal purposes. The Practice maintains confidentiality obligations, access controls, secure storage measures, staff awareness and training, and reasonable safeguards to ensure compliance with the Protection of Personal Information Act, 2013 (“POPIA”). Personal information is retained and disposed of in accordance with applicable legal, healthcare, and record retention requirements.

14. AVAILABILITY OF THE PAIA MANUAL

A copy of the PAIA Manual is available-

• Suite C25, Life Healthcare, Cedar Rd, Fourways, Johannesburg, Gauteng, 2055

• offices of The Practice/s for public inspection during normal business hours;

• to any person upon request and upon the payment of a reasonable prescribed fee; and

• to the Information Regulator upon request.

A fee for a copy of this PAIA Manual, as contemplated in annexure B of the Regulations, shall be payable per each A4-size photocopy made.

15. UPDATING OF THE PAIA MANUAL

The Practice/s’ Information Officers will update this PAIA Manual as necessary.

Issued by

_______________________________

Mrs CLAIRE KOURIE 2026/06/23

Annexure 1 | Form 1 – Request for a copy of the Guide

[Regulation 3]

TO: The Information Officer

_______________________________

(Address)

E-mail address: _______________________________

Fax number: _______________________________

Full names:
In my capacity as (mark with “x”):	Information officer ☐ Other ☐
*Name of public/private body (if applicable)**
Postal Address:
Street Address:
E-mail Address:
Facsimile:
Contact numbers:	Tel.(B): ______ Cellular: ______

Hereby request the following copy(ies) of the Guide:

Language (mark with “X”)	No of copies	Language (mark with ‘X’)	No of copies
Sepedi		Sesotho
Setswana		siSwati
Tshivenda		Xitsonga
Afrikaans		English
isiNdebele		isiXhosa
isiZulu

Manner of collection (mark with “x”):

Personal collection	Postal address	Facsimile	Electronic communication (Please specify)

Signed at ___________________ this _____ day of _____________ 20____

_______________________________

Signature of requester

Annexure 2 | Form 2 – Request for access to record

[Regulation 7]

NOTE:

1. Proof of identity must be attached by the requester.

2. If requests made on behalf of another person, proof of such authorisation, must be attached to this form.

TO: The Information Officer

______________________________________________________________

(Address)

E-mail address: _______________________________

Fax number: _______________________________

Mark with an “X”: Request is made in my own name ☐ Request is made on behalf of another person ☐

PERSONAL INFORMATION

Full Names
Identity Number
Capacity in which request is made (when made on behalf of another person)
Postal Address
Street Address
E-mail Address
Contact Numbers —	Tel. (B): ______ Facsimile: ______ Cellular: ______
Full names of person on whose behalf request is made (if applicable)
Identity Number (of that person)
Postal Address (of that person)
Street Address (of that person)
E-mail Address (of that person)
Contact Numbers —	Tel. (B): ______ Facsimile: ______ Cellular: ______

PARTICULARS OF RECORD REQUESTED

Provide full particulars of the record to which access is requested, including the reference number if that is known to you, to enable the record to be located. (If the provided space is inadequate, please continue on a separate page and attach it to this form. All additional pages must be signed.)

Description of record or relevant part of the record:
Reference number, if available
Any further particulars of record

TYPE OF RECORD

(Mark the applicable box with an “X”)

Record is in written or printed form	☐
Record comprises virtual images (this includes photographs, slides, video recordings, computer-generated images, sketches, etc)	☐
Record consists of recorded words or information which can be reproduced in sound	☐
Record is held on a computer or in an electronic, or machine-readable form	☐

FORM OF ACCESS

(Mark the applicable box with an “X”)

Printed copy of record (including copies of any virtual images, transcriptions and information held on computer or in an electronic or machine-readable form)	☐
Written or printed transcription of virtual images (this includes photographs, slides, video recordings, computer-generated images, sketches, etc)	☐
Transcription of soundtrack (written or printed document)	☐
Copy of record on flash drive (including virtual images and soundtracks)	☐
Copy of record on compact disc drive (including virtual images and soundtracks)	☐
Copy of record saved on cloud storage server	☐

MANNER OF ACCESS

(Mark the applicable box with an “X”)

Personal inspection of record at registered address of public/private body (including listening to recorded words, information which can be reproduced in sound, or information held on computer or in an electronic or machine-readable form)	☐
Postal services to postal address	☐
Postal services to street address	☐
Courier service to street address	☐
Facsimile of information in written or printed format (including transcriptions)	☐
E-mail of information (including soundtracks if possible)	☐
Cloud share/file transfer	☐
Preferred language (note that if the record is not available in the language you prefer, access may be granted in the language in which the record is available)	☐

PARTICULARS OF RIGHT TO BE EXERCISED OR PROTECTED

If the provided space is inadequate, please continue on a separate page and attach it to this Form. The requester must sign all the additional pages.

Indicate which right is to be exercised or protected
Explain why the record requested is required for the exercise or protection of the aforementioned right:

FEES

a) A request fee must be paid before the request will be considered.

b) You will be notified of the amount of the access fee to be paid.

c) The fee payable for access to a record depends on the form in which access is required and the reasonable time required to search for and prepare a record.

d) If you qualify for exemption of the payment of any fee, please state the reason for exemption.

Reason

You will be notified in writing whether your request has been approved or denied and if approved the costs relating to your request, if any. Please indicate your preferred manner of correspondence:

Postal address	Facsimile	Electronic communication (Please specify)

Signed at ___________________ this _____ day of _____________ 20____

_______________________________

Signature of Requester / person on whose behalf request is made

FOR OFFICIAL USE

_______________________________

Signature of Information Officer

Reference number:
Request received by:	(State Rank, Name And Surname of Information Officer)
Date received:
Access fees:
Deposit (if any):

Annexure 3 | Fees for access request

Item	Description	Amount
1.	The request fee payable by every requester	R140.00
2.	Photocopy/printed black & white copy of A4-size page	R2.00 per page or part thereof.
3.	Printed copy of A4-size page	R2.00 per page or part thereof.
4.	For a copy in a computer-readable form on: (i) Flash drive (to be provided by requestor); (ii) Compact disc — if provided by requestor / if provided to the requestor	R40.00 / R40.00 / R60.00
5.	For a transcription of visual images per A4-size page	Service to be outsourced. Will depend on quotation from Service provider.
6.	Copy of visual images
7.	Transcription of an audio record per A4-size page	R24.00
8.	Copy of an audio record on: (i) Flash drive (to be provided by requestor); (ii) Compact disc — if provided by requestor / if provided to the requestor	R40.00 / R40.00 / R60.00
9.	To search for and prepare the record for disclosure for each hour or part of an hour, excluding the first hour, reasonably required for such search and preparation. To not exceed a total cost of:	R145.00 / not exceeding R435.00
10.	Deposit: If search exceeds 6 hours	One third of amount per request calculated in terms of items 2 to 8.
11.	Postage e-mail or any other electronic transfer	Actual expense if any.

Annexure 4 | Form 3 – Outcome of request and of fees payable

(Regulation 8)

Note:

1. If your request is granted the-

(a) amount of the deposit, (if any), is payable before your request is processed; and

(b) requested record/portion of the record will only be released once proof of full payment is received.

2. Please use the reference number hereunder in all future correspondence.

To: ___________________________ Reference number: ___________________________

______________________________________________________________

Your request dated ______________, refers.

1. You requested:

Personal inspection of information at registered address of public/private body (including listening to recorded words, information which can be reproduced in sound, or information held on computer or in an electronic or machine-readable form) is free of charge. You are required to make an appointment for the inspection of the information and to bring this Form with you. If you then require any form of reproduction of the information, you will be liable for the fees prescribed in Annexure 3.

☐

2. You requested:

Printed copies of the information (including copies of any virtual images, transcriptions and information held on computer or in an electronic or machine-readable form)	☐
Written or printed transcription of virtual images (this includes photographs, slides, video recordings, computer-generated images, sketches, etc)	☐
Transcription of soundtrack (written or printed document)	☐
Copy of information on flash drive (including virtual images and soundtracks)	☐
Copy of information on compact disc drive (including virtual images and soundtracks)	☐
Copy of record saved on cloud storage server	☐

3. To be submitted

Postal services to postal address	☐
Postal services to street address	☐
Courier service to street address	☐
Facsimile of information in written or printed format (including transcriptions)	☐
E-mail of information (including soundtracks if possible)	☐
Cloud share/file transfer	☐
Preferred language: (note that if the record is not available in the language you prefer, access may be granted in the language in which the record is available)	☐

Kindly note that your request has been:

☐	Approved
☐	Denied, for the following reasons:
Reasons

4. Fees payable with regards to your request:

Item	Cost per A4 size page or part thereof/item	Number of pages/items	Total
Photocopy/printed black & white copy of A4-size page	R2.00 per page
Printed copy of A4-size page	R2.00 per page part thereof
For a copy in a computer-readable form: Flash drive / Compact disc (provided by requestor / provided to requestor)	R40.00 / R40.00 / R60.00
For a transcription of visual images per A4-size page	Service to be outsourced. Will depend on quotation from Service provider.
Copy of visual images
Transcription of an audio record per A4-size page	R24.00
Copy of an audio record: Flash drive / Compact disc (provided by requestor / provided to requestor)	R40.00 / R40.00 / R60.00
Postage e-mail or any other electronic transfer	Actual expense if any.
TOTAL

5. Deposit payable (if search exceeds six hours):

☐ Yes ☐ No

Hours of search	Amount of deposit (calculated on one third of total amount per request)

The amount must be paid into the following Bank account:

Name of Bank:
Name of account holder:
Type of account:
Account number:
Branch Code:
Reference Nr:
Submit proof of payment to:

Signed at ___________________ this _____ day of _____________ 20____

_______________________________

Information officer

[1]Section 17(1) of PAIA- For the purposes of PAIA, each public body must, subject to legislation governing the employment of personnel of the public body concerned, designate such number of persons as deputy information officers as are necessary to render the public body as accessible as reasonably possible for requesters of its records.

[2]Section 56(a) of POPIA- Each public and private body must make provision, in the manner prescribed in section 17 of the Promotion of Access to Information Act, with the necessary changes, for the designation of such a number of persons, if any, as deputy information officers as is necessary to perform the duties and responsibilities as set out in section 55(1) of POPIA.

[3]Section 11(1) of PAIA- A requester must be given access to a record of a public body if that requester complies with all the procedural requirements in PAIA relating to a request for access to that record; and access to that record is not refused in terms of any ground for refusal contemplated in Chapter 4 of this Part.

[4]Section 50(1) of PAIA- A requester must be given access to any record of a private body if: a) that record is required for the exercise or protection of any rights; b) that person complies with the procedural requirements in PAIA relating to a request for access to that record; and c) access to that record is not refused in terms of any ground for refusal contemplated in Chapter 4 of this Part.

[5]Section 14(1) of PAIA- The information officer of a public body must, in at least three official languages, make available a manual containing information listed in paragraph 4 above.

[6]Section 51(1) of PAIA- The head of a private body must make available a manual containing the description of the information listed in paragraph 4 above.

[7]Section 15(1) of PAIA- The information officer of a public body, must make available in the prescribed manner a description of the categories of records of the public body that are automatically available without a person having to request access.

[8]Section 52(1) of PAIA- The head of a private body may, on a voluntary basis, make available in the prescribed manner a description of the categories of records of the private body that are automatically available without a person having to request access.

[9]Section 22(1) of PAIA- The information officer of a public body to whom a request for access is made, must by notice require the requester to pay the prescribed request fee (if any), before further processing the request.

[10]Section 54(1) of PAIA- The head of a private body to whom a request for access is made must by notice require the requester to pay the prescribed request fee (if any), before further processing the request.

[11]Section 92(1) of PAIA provides that – “The Minister may, by notice in the Gazette, make regulations regarding- (a) any matter which is required or permitted by this Act to be prescribed; (b) any matter relating to the fees contemplated in sections 22 and 54; (c) any notice required by this Act; (d) uniform criteria to be applied by the information officer of a public body when deciding which categories of records are to be made available in terms of section 15; and (e) any administrative or procedural matter necessary to give effect to the provisions of this Act.”

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