Marius Scheepers & Company Attorneys


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Marius Scheepers & Company,
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Pretoria,
South Africa,
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Marius Scheepers and Company Attorneys and their associates accept no liability for any damages or losses suffered as a result of actions taken based on information contained herein. They are committed to regularly update all information that is subject to change from time to time. Any person may contact them for further information and to arrange for a consultation to deal with a specific issue or send an e-mail to mariusscheepers@irodo.com The information contained herein does not serve as alternative to legal advice that may be provided during a furrow assessment of the case at a proper consultation.


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Unemployment Insurance Act Regulations, 1966

(updated 01/03)

 

Published under

 

Government Notice (GN) R849 in Government Gazette (GG) 8683 of 29 April 1983

 

as amended by

 

GN R1235 in GG 8760 of 17 June 1983
GN R2613 in GG 8986 of 2 December 1983
GN R2775 in GG 9533 of 21 December 1984
GN R2487 in GG 9998 of 8 November 1985
GN R901 in GG 10234 of 16 May 1986
GN R1114 in GG 10262 of 6 June 1986
GN R2427 in GG 10522 of 21 November 1986
GN R2161 in GG 10958 of 2 October 1987
GN R2412 in GG 11014 of 30 October 1987
GN R2667 in GG 11053 of 4 December 1987
GN R419 in GG 11174 of 11 March 1988
GN R960 in GG 11308 of 20 May 1988
GN R2115 in GG 11548 of 21 October 1988
GN R272 in GG 11708 of 24 February 1989
GN R1707 in GG 12657 of 27 July 1990
GN R2962 in GG 12907 of 21 December 1990
GN R1884 in GG 13444 of 9 August 1991
GN R2585 in GG 14267 of 11 September 1992
GN R2936 in GG 14346 of 23 October 1992
GN R643 in GG 14742 of 16 April 1993
GN R1447 in GG 15050 of 13 August 1993
GN R1976 in GG 15211 of 22 October 1993, as corrected by GN R2054
in GG 15226 of 29 October 1993
GN R1701 in GG 16796 of 3 November 1995
GN R297 in GG 16992 of 23 February 1996
GN R1068 in GG 17283 of 28 June 1996
GN R249 in GG 17786 of 14 February 1997
GN R1498 in GG 19488 of 27 November 1998

 

Schedule

 

1        Definitions

 

            In these Regulations, unless the context otherwise indicates-

 

            ‘Act’ means the Unemployment Insurance Act, 1966 (Act 30 of 1966); and any word or expression to which a meaning has been assigned in the Act, shall bear the meaning so assigned to it;

 

            ‘annexure’ means an annexure to these Regulations;

 

            ‘Director-General’ means the Director-General: Labour;

 

            ‘identity document’ means an identity document referred to in section 8 of Act 72 of 1986 and includes an identity certificate referred to in section 9 of the said Act;

 

            ‘identity number’ means an identity number referred to in section 5 (2) of Act 72 of 1986;

 

            ‘Provincial Director’ means-

 

               (a)     in the Province of KwaZulu-Natal, the Provincial Director, Department of Labour, P.O. Box 940, Durban, 4000;

 

               (b)     in the Province of the Northern Cape, the Provincial Director, Department of Labour, Private Bag X5012, Kimberley, 8300;

 

               (c)     in the Northern Province, the Provincial Director, Department of Labour, Private Bag X9368, Pietersburg, 0700;

 

               (d)     in the Province of the North West, the Provincial Director, Department of Labour, Private Bag X2040, Mmabatho, 8681;

 

               (e)     in the Province of the Eastern Cape, the Provincial Director, Department of Labour, Private Bag X9005, East London, 5200;

 

               (f)      in the Province of Mpumalanga, the Provincial Director, Department of Labour, Private Bag X7263, Witbank, 1035;

 

               (g)     in the Province of the Free State, the Provincial Director, Department of Labour, P.O. Box 522, Bloemfontein, 9300;

 

               (h)     in the Province of Gauteng:

 

                       (i)       Gauteng South, in the Magisterial Districts of Alberton, Boksburg, Brakpan, Germiston, Heidelberg, Johannesburg, Kempton Park, Oberholzer, Randburg, Roodepoort, Vanderbijlpark, Vereeniging and Westonaria, the Provincial Director, Department of Labour, P.O. Box 4560, Johannesburg, 2000;

 

                       (ii)       Gauteng North, in the Magisterial Districts of Benoni, Bronkhorstspruit, Cullinan, Krugersdorp, Nigel, Pretoria, Randfontein, Soshanguve 1, Soshanguve 2, Springs and Wonderboom, the Provincial Director, Department of Labour, P.O. Box 393, Pretoria, 0001; and

 

                        (i)      in the Province of the Western Cape, the Provincial Director, Department of Labour, P.O. Box 872, Cape Town, 8000.

 

[Definition of ‘Provincial Director’ inserted by GN R1068 of 28 June 1996.]

 

            ‘reference book’ means a reference book referred to in section 3 (1) (b) (i) of the Blacks (Abolition of Passes and Co-ordination of Documents) Act, 1952 (Act 67 of 1952), and includes an identity document referred to in section 3 (1) (b) (ii) of the said Act, a document referred to in section 3 (2) of the said Act, a duplicate of such book or document and, in respect of foreign Blacks, also a passport and worker’s travel documents; and

 

            ‘reference book number’ means the number allocated to or the serial number of a reference book.

 

            ‘Regional Director’ ……

 

[Definition of ‘Regional Director’ amended by GN R272 of 24 February 1989 and by GN R2962 of 21 December 1990 and deleted by GN R1068 of 28 June 1996.]

[Regulation 1 substituted by GN R2115 of 21 October 1988.]

 

2        Production of Identity Documents or Reference Books

 

            A claims officer, duly authorised officer or other State employee or an agent may require an applicant for benefits or allowances or for the payment of an amount in terms of the Act to produce his identity document or reference book for inspection, but may not retain such document or book.

 

3        Appeals in Terms of Sections 21 and 27 of the Act

 

            (1) (a) An appeal to a committee in terms of section 27 (1) of the Act shall contain the following information:

 

              (i)       Name and address of appellant;

 

             (ii)       identity number or reference book number;

 

            (iii)       name and address of last employer;

 

            (iv)       date of application for benefits;

 

             (v)       office at which application made;

 

            (vi)       date of notification of decision of claims officer;

 

           (vii)       particulars of decision appealed against;

 

          (viii)       grounds on which appeal is based.

 

            (b) A committee may require the appellant to furnish such further information as it may deem necessary to enable it to deal with the appeal.

 

            (c) The committee shall notify its decision on the appeal, in writing, to the appellant and to the claims officer.

 

            (2) (a) An appeal to the board in terms of section 21 (1) of the Act shall be in duplicate and shall contain information on the following points:

 

              (i)       Name and address of appellant;

 

             (ii)       identity number or reference book number;

 

            (iii)       name and address of last employer;

 

            (iv)       date of application for benefits;

 

             (v)       office at which application made;

 

            (vi)       date of notification of decision of committee;

 

           (vii)       particulars of decision appealed against;

 

          (viii)       grounds on which appeal is based.

 

            (b) The board may require the appellant to furnish such further information as it may deem necessary to enable it to deal with the appeal.

 

            (c) The board shall notify its decision on the appeal, in writing, to the appellant and to the committee concerned.

 

4        Allowances Payable to Members of Board and Committees

 

            (1) A member of the board or of a committee, other than a member who is an officer, shall be paid a remuneration or allowance of, in the case of a board member, R60,00 per hour with a maximum of R477,00 per day and, in the case of a committee member, R50,00 per hour with a maximum of R398,00 per day, in respect of every hour during which such member attends or travels to or from a meeting of the board or of a committee, as the case may be.

 

[Subregulation (1) amended by GN R1235 of 17 June 1983 and substituted by GN R901 of 16 May 1986, by GN R1114 of 6 June 1986, by GN R2161 of 2 October 1987, by GN R1707 of 27 July 1990, by GN R2585 of 11 September 1992, by GN R2936 of 23 October 1992, by GN R1447 of 13 August 1993, by GN R1701 of 3 November 1995, by GN R297 of 23 February 1996, by GN R249 of 14 February 1997 and by GN R1498 of 27 November 1998.]

 

            (2) A member of the board or of a committee, other than an officer or other State employee, who is required to travel on the business of the board or of a committee shall-

 

                        (a)     if the journey or any portion thereof can be performed by using the transport service of Transnet Ltd. or of the South African Rail Commuter Corporation Ltd. be paid the amount of a first class return fare for such journey or part thereof;

 

[Para. (a) amended by GN R2585 of 11 September 1992.]

 

                        (b)     if the journey or any part thereof cannot be performed by using any of the services referred to in paragraph (a) or if it is impracticable in the circumstances to make use thereof, be reimbursed the cost of travelling by any other public transport service: Provided that if a member wishes to travel by air or shipping service, he shall obtain the prior approval of the Director-General;

 

                        (c)     if the journey or any part thereof cannot be performed by using any of the means of transport referred to in paragraph (a) or (b), or if is impracticable in the circumstances to make use thereof, be paid an allowance towards the cost of any other transport, including his own, at the rate prescribed from time to time for the use of private transport for official purposes by officers of the Public Service.

 

            (3) In addition to the allowances prescribed in subregulation (1), a member of the board or of a committee who has been appointed by the Minister to represent the interests of contributors and who loses wages as a result of attending any board, committee or subcommittee meeting which he is required to attend, shall be reimbursed the amount of such wages lost.

 

[Subregulation (3) amended by GN R1235 of 17 June 1983.]

 

            (4) For the purposes of this regulation ‘member’ includes an alternate who attends a meeting and acts in the stead of a member who is absent.

 

5        Registration of Employers

 

            (1) Every employer who is required to furnish the Director-General with prescribed particulars in terms of section 28 (1) of the Act shall furnish the particulars specified in Annexure UF 1.

 

            (2) The said particulars shall be forwarded by every such employer to the Unemployment Insurance Fund, Laboria Buildings, Paul Kruger Street, (P.O. Box 1851), Pretoria, 0001.

 

6        Notification in Terms of Section 28 of the Act (4) of Particulars of Contributors

 

            (1) Every employer shall, within one month of taking into his employment a contributor who is not in possession of a contributor’s record card or who is unable to produce such card, whether or not such contributor was previously provided with such card, furnish the Director-General with the particulars specified in Annexure UF 85, in respect of each such contributor.

 

            (2) Such particulars shall be furnished by forwarding Annexure UF 85, duly completed, to the Employment Insurance Fund, Laboria Buildings, Paul Kruger Street, (P.O. Box 1851), Pretoria, 0001.

 

6A     Application to be exempted from liability to contribute to the Unemployment Insurance Fund

 

            An application to be exempted from liability to contribute to the Unemployment Insurance Fund in terms of section 2 (5) (a) (i) of the Act shall be in the form of and contain the information called for in Annexure UF 64.

 

[Regulation 6A inserted by GN R643 of 16 April 1993.]

 

7        Payment of Contributions

 

            (1) The amount of the contributions which an employer is required to pay the Director-General in terms of section 29 (3) of the Act shall be forwarded by such employer to the Unemployment Insurance Fund, Laboria Buildings, Paul Kruger Street, (P.O. Box 1851), Pretoria, 0001.

 

            (2) When an employer pays any contributions to the Unemployment Insurance Fund in terms of section 29 (3) of the Act, such contributions shall be accompanied by a statement in the form of Annexure UF 3 which shall contain the particulars specified therein and shall be certified by him as true and correct.

 

[Subregulation (2) substituted by GN R643 of 16 April 1993.]

 

            (3) Any person who has been an employer and who receives from the Fund a form UF 3 in respect of any month in which he has not employed any contributor, shall return such form, duly signed, to the Fund with an endorsement to that effect and stating the date upon which a contributor was last employed by him.

 

8        Contributors’ Record Cards

 

            (1) The record card which the Director-General is required to issue in terms of section 33 (1) of the Act shall be in the form of Annexure UF 74, and shall be forwarded to the employer of the contributor concerned on receipt of the prescribed particulars referred to in regulation 6.

 

            (2) Every employer shall keep, in respect of every contributor employed by him, a record showing-

 

                        (a)     the name of such contributor;

 

                        (b)     the date upon which such contributor commenced employment with him as a contributor;

 

                        (c)     the date upon which his employment as a contributor terminated;

 

                        (d)     the weekly or monthly rate of earnings of such contributor during the 13 weeks immediately preceding the date of termination of such employment;

 

                        (e)     the date upon which the employer received the contributor’s record card (UF 74) of such contributor from the said contributor, or from the Director-General, as the case may be;

 

                        (f)      the date upon which the employer disposed of such contributor’s record card;

 

                        (g)     the manner of such disposal.

 

            (3) The Director-General may, on receipt of an application in the form of Annexure UF 107 and upon payment of a fee of 50c, issue a contributor’s record card in substitution for any such record card which he is satisfied has been lost or destroyed and he may also, on receipt of an application in the form of Annexure UF 107 and upon payment of such amount, issue a contributor’s record card in respect of any person, including a deceased person, on submission of satisfactory proof that such person was a contributor at any time since 1 January 1950: Provided that the Director-General may, at his discretion, issue a record card, free of charge, if he is satisfied that the circumstances warrant such free issue.

 

9        Statement to Accompany Contributor’s Record Card

 

            An employer who is required in terms of section 33 (3) of the Act to forward a contributor’s record card to a claims officer shall forward with such card a statement in the form of and containing the particulars specified in Annexure UF 125.

 

10      Payment of Unemployment benefits in Terms of Section 35 of the Act

 

            (1) An application for benefits in terms of section 35 of the Act shall be presented by the applicant personally at an office of the Department of Manpower, a magistrate, a commissioner, a labour bureau or an agent, as the case may be, for transmission to the claims officer having jurisdiction and shall be in the form of and contain the particulars specified in Annexure UF 123.

 

            (2) Whenever a contributor has applied for benefits he shall, when making such application or as soon as possible thereafter, hand his contributor’s record card to the claims officer having jurisdiction in the area in which such contributor resides, or to a duly authorised officer or other State employee, or to an agent, as the case may be.

 

            (3) A claims officer or duly authorised officer or other State employee or an agent may retain a contributor’s record card, which has been handed to him in terms of subregulation (2) if he deems it expedient to do so, and shall in such event furnish the contributor with a contributor’s check card in the form of Annexure UF 7.

 

            (4) The claims officer, duly authorised officer, other State employee or an agent who has retained the contributor’s record card of a contributor, shall return to such contributor the contributor’s record card in exchange for the check card, if he is satisfied that such contributor has obtained employment, or if he no longer requires the said contributor’s record card.

 

            (5) An applicant for employment benefits shall, at such times and places as the claims officer may determine, sign an unemployment register in the form of and containing the particulars specified in Annexure UF 103 or UF 103A.

 

            (6) Notwithstanding the provisions of subregulation (5), a claims officer may, in individual cases, accept other evidence satisfactory to him that a contributor is unemployed and is capable of and available for work.

 

            (7) (a) An application for the payment of further benefits to a contributor in terms of section 35 (14) of the Act shall be in the form of and contain the particulars specified in Annexure UF 139.

 

            (b) Such application shall be submitted in duplicate to the claims officer having jurisdiction in the area in which the applicant resides.

 

                        (8) ……

 

[Subregulation (8) deleted by GN R960 of 20 May 1988.]

 

11      Payment of Illness Benefits in Terms of Section 36 of the Act

 

            (1) An application for illness benefits in terms of section 36 of the Act shall be made by the person entitled thereto, or by a person authorised by the claims officer in terms of section 36 (3) (b) of the Act to make such application and shall be in the form of and contain the particulars specified in Annexure UF 86. Such application shall be presented at or forwarded to an office of the Department of Manpower, a magistrate, commissioner, labour bureau or an agent, as the case may be, for transmission to the claims officer having jurisdiction in the area in which the applicant resides or resides temporarily and shall be accompanied by the contributor’s record card of the applicant, unless such applicant is not in possession of such card, in which case the said card shall be submitted to the claims officer as soon as possible thereafter.

 

            (2) A contributor whose application for illness benefits has been approved by a claims officer may be paid such benefits by cheque in respect of any period approved by the claims officer in terms of the Act.

 

            (3) Payments for subsequent periods, may, subject to the provisions of section 34 (5) of the Act, be approved by the claims officer on receipt of the details and declaration specified in, and in the form of Annexure UF 87. Such form shall be signed by the contributor in the space provided for the purpose: Provided that, if the claims officer is satisfied that such contributor is unable to sign such form, he may accept the signature of such person as he may deem fit to sign on behalf of such contributor.

 

            (4) (a) The medical certificates on Annexures UF 86, UF 87 and UF 140, shall be completed and signed by the medical practitioner, chiropractor or homeopath by whom the applicant has been treated: provided that a claims officer may require an applicant to be examined by a medical officer, medical practitioner, chiropractor or homeopath nominated by the claims officer.

 

            (b) The costs of a medical examination required by a claims officer under paragraph (a) shall be charged against the Unemployment Insurance Fund.

 

[Subregulation (4) substituted by GN R960 of 20 May 1988.]

 

            (5) If the nature of the illness can be described in the medical certificate forming part of Annexure UF 86, UF 87 or UF 140 in uncertain terms or as ‘disease-entity’ or ‘symptom-complex’, the contributor shall furnish a clinical report from the medical practitioner, chiropractor or homeopath describing the symptoms and nature of the complaint from which such contributor is suffering.

 

[Subregulation (5) substituted by GN R960 of 20 May 1988.]

 

            (6) (a) An application for the payment of further benefits to a contributor in terms of section 36 (9) of the Act shall be in the form of the contain the particulars specified in Annexure UF 140.

 

            (b) Such application shall be submitted in duplicate to the claims officer having jurisdiction in the area in which the applicant resides.

 

12      Payment of Maternity Benefits in Terms of Section 37 of the Act

 

            (1) An application for maternity benefits in terms of section 37 of the Act shall be made by the person entitled thereto and shall be in the form of and contain the particulars specified in Annexure UF 92. Such application shall be presented at or forwarded to an office of the Department of Manpower, a magistrate, commissioner, labour bureau or an agent, as the case may be, for transmission to the claims officer having jurisdiction in the area in which the contributor resides or resides temporarily and shall be accompanied by the contributor’s record card of the applicant unless such applicant is not in possession of such card, in which case the said card shall be submitted to the claims officer as soon as possible thereafter.

 

            (2) A contributor who has applied for benefits in terms of section 37 shall submit to the claims officer a declaration in the form of Annexure UF 93 covering each period up to and including the date of birth of the child in respect of which pre-natal maternity benefits are claimed.

 

            (3) The contributor shall, as soon as possible after the birth of the child, submit to the claims officer in the form of Annexure UF 94 a declaration made by her and a notification of birth by a medical practitioner or a midwife and, if required by the claims officer a further declaration in the form of Annexure UF 95, covering each period subsequent to the date of birth of the child, in respect of which post-natal maternity benefits are claimed or any period up to and including the date of birth of the child in respect of which a declaration in the form of Annexure UF 93 has not been made.

 

            (4) A contributor who applies for benefits in terms of section 37 after her child has been born shall lodge a form UF 92, duly completed except for the medical certificate appearing therein, with the claims officer together with a declaration and notification of birth in the form of Annexure UF 94 completed by her and a medical practitioner or a midwife, and if required by the claims officer at any time, a declaration in the form of Annexure UF 95.

 

            (5) The claims officer may, if he deems it expedient, require the applicant to produce the birth certificate of the child in respect of whose birth the application has been made, or he may accept such birth certificate together with a declaration in the form of Annexure UF 95 in lieu of a completed Annexure UF 94.

 

            (6) The medical certificate on Annexure UF 92 shall, except where not required in terms of subregulation (4), be completed and signed by the medical practitioner by whom the applicant has been examined: Provided that a claims officer may require an applicant to be examined by a medical officer or practitioner nominated by him.

 

            The fee for a medical examination conducted at the instance of a claims officer shall be a charge upon the Unemployment Insurance Fund.

 

            (7) A contributor whose application for benefits in terms of section 37 of the Act has been approved may be paid such benefits by cheque in respect of any period approved by the claims officer.

 

12A   Payment of Adoption Benefits in Terms of Section 37A of the Act

 

            (1)(a) An application for adoption benefits in terms of section 37A of the Act shall-

 

              (i)       be made by the person claiming such benefits;

 

             (ii)       be in the form of and contain the particulars specified in Annexure UF 92A;

 

            (iii)       be presented at, or forwarded to an office of the Department of Manpower, a magistrate or an agent, as the case may be, for transmission to the claims officer having jurisdiction in the area in which the contributor resides or resides temporarily; and

 

            (iv)       be accompanied by-

 

               (aa)   the contributor’s record card (UF 74) of the applicant unless the applicant is not in possession of such card, in which case the said card shall be submitted to the claims officer as soon as possible thereafter;

 

               (bb)   a certified copy of the birth certificate of the child concerned and of the application to a children’s court in terms of section 18 (2) of the Child Care Act, 1983 (Act 74 of 1983), for the adoption of that child; and

 

               (cc)    if an adoption order has already been issued by the children’s court, a certified copy of that order.

 

            (b) If the children’s court has not already issued such an order on the date of application for adoption benefits, a certified copy of the order shall be submitted to the claims officer, as soon as possible after it has been issued.

 

            (c) If the date of the application to a children’s court in terms of section 18 (2) of the Child Care Act, 1983, does not appear on the adoption order, documentary proof of that date shall be submitted.

 

[Subregulation (1) substituted by GN R643 of 16 April 1993.]

 

            (2) A contributor who has applied for benefits in terms of section 37A of the Act shall submit to the claims officer a declaration in the form of Annexure UF 93 (A) in respect of each further period of unemployment until adoption benefits have been paid to the contributor for a period of twenty-six weeks.

 

            (3) A contributor whose application for benefits in terms of section 37A of the Act has been approved may be paid such benefits by cheque in respect of any period approved by the claims officer.

 

[Regulation 12A inserted by GN R2412 of 30 October 1987.]

 

13      Payments to Dependants of Deceased Contributors in Terms of Section 38 of the Act

 

            (1) An application for a payment in terms of section 38 of the Act shall, where the applicant is a widow or an invalid widower, be in the form of and contain the information called for in Annexure UF 126 and where the applicant is a person other than a widow or widower, be in the form of an contain the information called for in Annexure UF 127.

 

[Subregulation (1) amended by GN R1235 of 17 June 1983 and substituted by GN R2412 of 30 October 1987.]

 

            (2) An application referred to in subregulation (1) shall be accompanied by-

 

                        (a)     the contributor’s record card of the deceased contributor;

 

                        (b)     the death certificate relating to the death of such contributor: Provided that the Director-General may accept a post-mortem certificate or a burial order in lieu of a death certificate;

 

                        (c)     a certificate from the last employer of the deceased contributor in the form of and containing the information called for in Annexure UF 128; and

 

                        (d)     where the application is made by a widow or a widower, the marriage certificate of the deceased contributor: Provided that in the case of a widow or a widower who was a participant in a customary union according to indigenous law and custom, where neither the man nor the woman was a party to a subsisting marriage, the Director-General may accept such evidence as he may deem fit of the existence of such customary union.

 

[Para. (d) amended by GN R1235 of 17 June 1983 and by GN R2412 of 30 October 1987 and substituted by GN R1884 of 9 August 1991.]

 

            (3) An employer who employed a deceased contributor, shall, at the request of the Director-General, a regional director or an applicant for payment in terms of section 38 of the Act forward forthwith to the Director-General, such regional director or such applicant, as the case may be, the contributor’s record card of such deceased contributor, together with a certificate in the form of Annexure UF 128 containing the information called for therein in regard to such deceased contributor.

 

[Subregulation (3) amended by GN R1884 of 9 August 1991.]

 

            (4) The Director-General, a regional director or the board may require an applicant or any person who was the employer of a deceased contributor to furnish such other information as the Director-General, such regional director or the board, as the case may be, may deem necessary to enable proper consideration to be given to an application for a payment in terms of section 38 of the Act.

 

[Subregulation (4) amended by GN R1884 of 9 August 1991.]

 

14      Payment of Special Weekly Allowances in Terms of Section 48 of the Act

 

            (1) The notification to a claims officer by a contributor in terms of section 48 (2) shall be in the form of and contain the particulars specified in Annexure UF 79.

 

            (2) The statement which an employer may be required to transmit weekly to a claims officer in terms of section 48 (3) shall be in the form of and contain the particulars specified in Annexure UF 80.

 

15      Value of Remuneration in Kind

 

            (1) Should remuneration in kind be paid to a contributor, the value thereof is calculated as follows in terms of section 50 (3), read with section 62 (1) (m) of the Act:

 

               (a)     In the case of a contributor who is employed otherwise than in agriculture and that contributor is provided by his employer with food or quarters or with both food and quarters, the weekly or monthly value of such food or quarters, or food and quarters, for the purposes of section 50 of the Act, shall, in respect of food, be at the rate of 17 per cent of the weekly or monthly amount, as the case may be, of the earnings paid or payable in cash to such contributor, and shall, in respect of quarters, be at the rate of 8 per cent of the amount of such earnings and, in respect of food and quarters, be at the rate of 25 per cent of the amount of such earnings;

 

               (b)     in the case of a contributor who is employed in agriculture, the value of remuneration in kind is in terms of section 50 (3), read with section 62 (1) (m) of the Act, determined as the greater of-

 

              (i)       30 per cent of the monthly earnings paid or payable to a contributor in cash; or

 

                      (iii)       the amount of one hundred rand.

 

            (2) Notwithstanding the provisions of subregulation (1) an employer and a contributor in agriculture can in terms of section 50 (3), read with section 62 (1) (m) of the Act, agree in writing on the value of remuneration in kind subject to such value being not less favourable as determined in paragraph (b) (ii) of subregulation (1) and the agreed value shall be valid for the purposes of section 50 of the Act.

 

[Regulation 15 substituted by GN R643 of 16 April 1993.]

 

15A   Safe-keeping of Agreement

 

            In terms of section 62 (1) (m) of the Act it is prescribed that an employer shall keep a copy of the written agreement as intended in subregulation 15 (2) for a period of three years after the date of termination of employment of the contributor.

 

[Regulation 15A inserted by GN R643 of 16 April 1993.]

 

16      Repeal and Savings

 

            (1) The Regulations published under Government Notice R1619 of 27 July 1979, as amended by the Regulations published under Government Notices R2667 of 30 November 1979, R1532 of 25 July 1980, R2089 of 17 October 1980, R1862 of 4 September 1981, and R2204 of 15 October 1982, are hereby repealed.

 

            (2) Anything done under any provisions of a regulation repealed by subregulation (1) shall be deemed to have been done under the corresponding provisions of these Regulations.

 

17      Commencement

 

            These Regulations shall come into operation on the 1st day of May 1983.

 

Annexures

 

Annexure UF 1

 

[Annexure UF 1 amended by GN R2613 of 2 December 1983, GN R2775 of 21 December 1984, GN R2487 of 8 November 1985, GN R2427 of 21 November 1986, GN R419 of 11 March 1988 and GN R1707 of 27 July 1990.]

 

NOTIFICATION BY EMPLOYER IN TERMS OF SECTION 28 (1)

 

To the Unemployment Insurance Fund

Laboria Buildings

Paul Kruger Street

P.O. Box 1851

Pretoria

0001

 

            The following particulars are furnished in terms of section 28 (1) of the Unemployment Insurance Act, 1966, and are certified to be correct.

 

Date ---------------------------------------------------------- ................  .....................................................................................

Signature of employer or duly authorised agent

 

1. Date on which contributor(s) first employed..............................................................................................................

 

2. Name under which business is carried on (block letters)...............................................................................................

 

3. Address to which correspondence is to be sent ...........................................................................................................

 

4. Full christian name(s), surname, residential address/es (not P.O. Box) and identity number(s) of OWNER or PARTNERS. In the case of a COMPANY or CLOSE CORPORATION indicate registered name ...................................

.............................................................................................................................................................................................

.............................................................................................................................................................................................

.............................................................................................................................................................................................

 

5. (a) Address where business premises are situated .........................................................................................................

(b) Magisterial district in which business premises are situated.........................................................................................

 

6. Nature of business.......................................................................................................................................................

 

7. Number of contributors employed .............................................................................................................................

 

8. If this return is in respect of the head office of a business, state-

      (a) names and addresses of branches .......................................................................................................................

.......................................................................................................................................................................................

.------------------------------------------------------------------------------------------------------------------------------------------------------------- .   

.------------------------------------------------------------------------------------------------------------------------------------------------------------- .   

(b) whether or not branches will be responsible for submission of returns and contributions direct..................................

 

9. If this return is in respect of a branch of the business, state-

     (a) name and address of head office (in the Republic) ..............................................................................................

     (b) whether returns and contributions will be submitted-

     (1) direct ................................................................................................................................................................

     or

     (2) through your head office ...................................................................................................................................

 

N.B.-A separate return should be rendered in respect of each individual business unless permission is obtained to submit a consolidated return.

 

Annexure UF 3

 

[Annexure UF 3 amended by GN R1235 of 17 June 1983, GN R2487 of 8 November 1985 and GN R2427 of 21 November 1986.]

 

To the Unemployment Insurance Fund

Laboria Buildings

Paul Kruger Street

P.O. Box 1851

Pretoria

0001

 

Return for the month --------------  only

 

In terms of section 29 (3) of the Unemployment Insurance Act, 1966, 1 forward herewith the total amount as shown in column F hereunder, being all contributions due in respect of myself and the contributors employed by me during the above-mentioned month.

 

I hereby certify that all details contained herein are true and correct.

 

Date --------------------------------------------------------- ................  .....................................................................................

Signature of employer or duly authorised agent

 

 

If no contributors were employed during the month, state date in the adjacent space when a contributor was last employed and return this form.

 

Date ....................................................................................

 

A

B

C

D

E

F

 

 

 

 

 

Contribution payable on earnings

 

 

 

Code No.

Republic of

Number of contributors

By employer at the rate of 0,9 per cent

By contributors at the rate of 0,9 per cent

Total: Columns D plus E

 

 

 

 

 

R          c

R          c

R          c

 

 

1

South Africa

 

 

 

 

 

 

2

Transkei

 

 

 

 

 

 

3

Bophuthatswana

 

 

 

 

 

 

4

Venda

 

 

 

 

 

 

5

Ciskei

 

 

 

 

 

 

Totals………..…………………………………………...

 

 

 

Total contributions payable

 

Annexure UF 7

 

CONTRIBUTOR'S CHECK CARD

 

      Contributor's record card of the undermentioned contribution handed in at
..............................................................................................................

Office stamp

 

....................................................................

Signature of receiving officer

 

 

IDENTITY PARTICULARS

 

Contributor's surname ..........................................................................................................................................................

Contributor's first name .......................................................................................................................................................

Identity/Reference Book No. ...............................................................................................................................................

UF Serial No. .......................................................................................................................................................................

.........................................................................

Specimen signature of contributor

 

Annexure UF 64

 

[Annexure UF 64 inserted by GN R643 of 16 April 1993.]

 

APPLICATION TO BE EXEMPTED FROM LIABILITY TO CONTRIBUTE TO THE UNEMPLOYMENT INSURANCE FUND IN TERMS OF SECTION 2 (5) (a) (1) OF THE ACT

 

The Unemployment Insurance Commissioner

P.O. Box 1851

PRETORIA

0001

 

I hereby, in terms of section 2 (5) (a) (i) of the Unemployment Insurance Act, 1966, make application that the persons or category of persons mentioned below not be regarded as contributors in the application of the said Act:

 

       1.          Name of employer.........................................................................................................................................

 

       2.          Address...........................................................................................................................................................

 

                 .........................................................................     Postal code ......................................................................

 

                 Telephone number .........................................................     Dialing code ......................................................

 

       3.          My business is already registered with the Unemployment Insurance Fund and the reference number is...........

 

       4.          Nature of business...........................................................................................................................................

 

       5.          Date of commencement of business................................................................................................................

 

       6.          Particulars of class of persons or business or area in respect of whom or of which exemption is required:

 

          .....................................................................................................................................................................

 

               6.1        Number of employees employed ..........................................................................................................

 

               6.2        The activities of the business are seasonal bound and the nature of the seasonal activities and the duration of the seasons are as follows:

 

                        ............................................................................................................................................................

 

                        ............................................................................................................................................................

 

       *           In the event of application for exemption on financial grounds, full details of your financial position must accompany this application.

 

       **         Any other reason in motivation of your application must be attached, please.

 

I declare that before I lodged this application, I discussed the matter with the employees concerned who indicated that they are also desirous to be exempted from the provisions of the Act.

 

.......................................................................................................
Signature of employer or responsible person

 

 

.......................................................................................................
Signature of person on behalf of the employees concerned

 

Date ...............................................................................................

 

Annexure UF 74

 

[Annexure UF 74 amended by GN R960 of 20 May 1988.]

 

 

Annexure UF 79

 

[Annexure UF 79 amended by GN R1235 of 17 June 1983.]

 

APPLICATION FOR SPECIAL WEEKLY ALLOWANCE IN TERMS OF SECTION 48

 

To the Claims Officer

Department of Manpower

.....................................................................................................

 

I hereby apply for a special weekly allowance in terms of section 48 of the Unemployment Insurance Act, 1966, and notify you that, after having become unemployed, I have accepted employment at less than half the average weekly earnings received by me during the period of three months immediately prior to the date upon which I became unemployed.

 

I declare that the information given below is true and correct in every respect.

 

     ..............................................................................

                                                                                                                Signature of applicant

Date ........................................................................

 

DETAILS TO BE FILLED IN BY APPLICANT

 

1. Full name (block letters) ...........................................................................................................................................
......................................................................................................................................................................................

 

2. Address......................................................................................................................................................................
......................................................................................................................................................................................

 

3. Identity/Reference Book No. ....................................................................................................................................

 

4. My present employer is:

(a) Name .......................................................................................................................................................................

(b) Address.....................................................................................................................................................................
......................................................................................................................................................................................

 

5. I am employed as ......................................................................................................................................................

 

6. My present rate of earnings is....................................................................................................................................

 

7. I was employed as follows during the three months immediately prior to the date I became unemployed:

 

Name of employer

Address of employer

Employed as

Rate of earnings per
week/month

 

 

 

 

.....................................................

.......................................................................

......................................................

......................................

.....................................................

.......................................................................

......................................................

......................................

.....................................................

.......................................................................

......................................................

......................................

 

 

 

 

 

Annexure UF 80

 

SPECIAL WEEKLY ALLOWANCE IN TERMS OF SECTION 48

 

To the Claims Officer

Department of Manpower


.................................................................................

 

         I hereby certify that .................................................................................................................................................

                                                                            (Name of employee)

 

whose identity/reference book number is ................................ has been employed by me as a ..........................during the week ended .....................................................................and that the undermentioned particulars regarding him are correct in respect of that week:

 

Rate of earnings per week/month

Deductions

Amount paid

 

 

 

..........................................................

..................................................................

......................................................

..........................................................

..................................................................

......................................................

..........................................................

..................................................................

......................................................

 

 

 

 

                                                                          ...........................................................................................

                                                                                                 Signature of employer

 

Date .................................................................................

 

Annexure UF 85

 

[Annexure UF 85 amended by GN R1235 of 17 June 1983.]

 

NOTIFICATION OF EMPLOYMENT OF PERSONS NOT IN POSSESSION
OF CONTRIBUTORS' RECORD CARDS

 

(Use form for more than one contributor if more than one card is required)

 

The Unemployment Insurance Fund

Laboria Buildings

Paul Kruger Street

P.O. Box 1851

Pretoria

0001

 

I have to inform you that the following persons who will be contributors to the Unemployment Insurance Fund, were taken into my employment on the dates specified and have indicated that they are not in possession of contributors' record cards:

 

Name of contributor (block letters)

*Number of-

(a) identity document

(b) reference book

(c) passport

(d) permanent residence permit

(e) temporary work permit

(f) worker's travel document

Race

Sex

Date employed

Surname (and maiden name where applicable)

First names (in full)

 


...............................................


........................................


............................................................


...................


......................


...............................

...............................................

........................................

............................................................

...................

......................

...............................

...............................................

........................................

............................................................

...................

......................

...............................

 

 

 

 

 

 

 

* Insert (a), (b), (c), (d), (e) or (f), whichever is applicable, in front of each number entered.

 

Trading name and address of business (in block letters) .................................................................................................

.............................................................................................................................................................................................

Employer's UIF Registration No. (See return form UF 3) .............................................................................................

 

Employer's telephone No .................................................................

 

I hereby certify that the above particulars are correct and that the identity numbers and other numbers in column 3 and full names have been verified from the identity documents issued in terms of the Population Registration Act, reference books or from other identity documents produced by the contributors concerned.

 

                                                                         ............................................................................................

                                                                                    Signature of employer or duly authorised agent

 

Date or date stamp ........................................................

 

Annexure UF 86

 

[Annexure UF 86 amended by GN R1235 of 17 June 1983, by GN R960 of 20 May 1988 and by GN R1976 of 22 October 1993.]

 

 

Annexure UF 87

 

[Annexure UF 87 amended by GN R960 of 20 May 1988 and by GN R1976 of 22 October 1993.]

 

 

Annexure UF 92

 

APPLICATION FOR MATERNITY BENEFITS IN TERMS OF SECTION 37

 

To the Claims Officer

Department of Manpower

 

1. I hereby apply for maternity benefits in terms of section 37 of the Unemployment Insurance Act, 1966, and declare that: *(a) I am pregnant; (b) I stopped work and since that date I have not been entitled to, nor have I received, from any employer one third or more of my normal earnings; *(c) I gave birth to a child and the particulars are shown in the attached completed form UF 94.

 

I further declare that the information given by me on this form is true and correct and that I am aware that it is an offence to knowingly make a false statement on this form.

 

* Delete whichever is not applicable.

 

2. Surname (in block letters) --------------------------------------    3. First names--------------------------------------------

 

4. Address --------------------------------------------------------------------------------------------------------------------------

 

5. Identity/Reference book number-------------------------------    6. Race ---------------------------------------------------

 

7. Date of birth ----------------------------------------------------    8. Trade or occupation ---------------------------------

 

9. Details of employment:

 

Name of employer

Address of employer

Employed as contributor

Employed as non-contributor

*Earnings

*Value of food and/or quarters

*Other allowances (specify nature and amount)

From

To

From

To

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* Indicate per week/per month.

 

10. Date on which you stopped working-------------------------    11. Are you still in employment? (Yes/No) ----------

 

12. If you have returned to work, state date---------------------    13. Have you ever applied for

 unemployment/maternity/illness benefits? (Yes/No) ----------------    If so state:  (a) Office -----------------------------------

(b) Date of application--------------------------------------------------    (c) UF Serial No. ----------------------------------------

(d) Name under which applied  ---------------------------------------------------------------------------------------------------------

 

Witness -------------------------------------------------------------------    -------------------------------------------------------------
Date -----------------------------------------------------------------------                                 Signature of applicant

 

14. Medical certificate (to be completed by a medical practit ioner if applicant is still pregnant):

 

I (name of medical practitioner) --------------------------------------------------------   Qualifications ---------------------

Address ----------------------------------------------------------------- hereby certify that ..................................................... was

(name of applicant)

examined by me, that in my opinion she is pregnant, and that from my examination and the information furnished by her, I consider the expected date of her confinement to be               

 

Date ---------------------------------------------------             --------------------------------------------------------------------------

Signature of medical practitioner

 

Note.-If child has already been born, form UF 94 should be completed.

 

Annexure UF 92A

 

[Annexure UF 92A inserted by GN R2412 of 30 October 1987 and substituted by GN R643 of 16 April 1993.]

 

 

Annexure UF 93

 

DECLARATION BY APPLICANT FOR PRE-NATAL MATERNITY BENEFITS

 

To the Claims Officer

Department of Manpower

 

...................................................................................

 

1. I declare that I am still pregnant and have not worked since the date of my application for maternity benefits. I further declare that since that date I have not been entitled to, nor have I received, from any employer one third or more of my normal earnings. I furnish the following particulars which I declare to be true and correct and I am aware that it is an offence to knowingly make false statements on this form.

 

2. Surname (block letters) .............................................................................................................................................

 

3. First names ...............................................................................................................................................................

 

4. Residential address .....................................................................................................................................................

 

5. Address to which cheque should be posted ..................................................................................................................

 

6. Identity/Reference Book No. ....................................................................................................................................

 

7. Expected date of confinement ..................................................................................................................................

 

Witness ................................................................................

 

Date .....................................................................................     ...........................................................................................

                                                                                             (Signature of applicant)

 

Annexure UF 93A

 

[Annexure UF 93A inserted by GN R2412 of 30 October 1987.]

 

L.W. VORM MOET OP OF NA ................................................................................................... VOLTOOI WORD

N.B. FORM TO BE COMPLETED ON OR AFTER

 

VERKLARING DEUR PERSOON WAT AANSOEK DOEN OM AANNEMINGSVOORDELE

DECLARATION BY APPLICANT FOR ADOPTION BENEFITS

 

Aan die Eisebeampte, Departement van Mannekrag,

Verw. Nr.

 

 

 

 

 

 

 

 

 

 

 

 

 

To the Claims Officer, Department of Manpower,

 Ref. No.

 

 

.............................................................................................................................................................................................

 

1.

Ek varklaar dat ek sedert die datum van my aansoek om aannemingsvoordele nie gewerk het nie. Ek verstrek die volgende besonderhede an verklaar dat dit juis en korrek is. Ek is daarvan bewus dat dit 'n misdryf is om opsetlik valse verklarings op hierdie vorm te doen.

1.

I declare that I have not worked since the date of my application for adoption benefits. I furnish the following particulars which I declare to be true and correct and I am aware that it is an offence to knowingly make false statements on this form.

 

 

 

 

2.

Familienaam (in blokletters) ......................................................................................................................................
Surname (block letters)

 

 

 

 

3.

Voorname ..................................................................................................................................................................
First names

 

 

 

 

4.

Woonadres .................................................................................................................................................................
Residential address

 

 

 

 

5.

Adres waarheen tjek gepos moet word ........................................................................................................................
Address to which cheque should be posted

 

...................................................................................................................................................................................

 

 

 

 

6.

PERSOONS-/IDENTITEITS-/BEWYSBOEKNOMMER ............................................................................................
IDENTITY/REFERENCE BOOK NUMBER

 

 

 

 

 

 

 

 

Getuie: ....................................................................................

Witness

 

 

 

 

Datum ....................................................................................

Date

..................................................................................

             Handtekening van applikant

                 Signature of applicant

 

 

 

L.W. 'n Eggenoot mag nie as getuie teken nie.

N.B. A husband may not sign as witness.

 

 

 

 

     OPMERKINGS:

     NOTES:

 

 

 

 

1.

Hierdie vorm moet slegs geteken word ten opsigte van 'n tydperk gedurende welke u nie in diens was nie.

1.

This form should be signed only in respect of a period during which you have not been employed.

 

 

 

 

2.

Dit is 'n misdryf om 'n opsetlike valse verklaring op hierdie vorm te doen. Die straf by skuldigbevinding is 'n boete van hoogstens R500 of gevangenisstraf vir 'n tydperk van hoogstens een jaar, of beide sodanige boete en gevangenisstraf.

2.

It is an offence to knowingly make a false statement on this form. The penalty upon conviction is a fine not exceeding R500, or imprisonment not exceeding one year, or both such fine and imprisonment.

 

Annexure UF 94

 

[Annexure UF 94 amended by GN R1235 of 17 June 1983.]

 

DECLARATION BY APPLICANT FOR POST-NATAL MATERNITY BENEFITS

 

To the Claims Officer

Department of Manpower

 

-----------------------------------------------

 

1. 1 declare that I have not worked since I was last employed immediately prior to the date of my application for maternity benefits except as shown in item 6 hereunder and that I have not been entitled to, nor have I received, from any employer one third or more of my normal earnings. I further declare that a child was born to me and that the particulars shown in the Notification of Birth hereunder refer to that child. The information given by me on this form is true and correct and I am aware that it is an offence to knowingly make false statements on this form.

 

2. Surname (block letters) .............................................................................................................................................

 

3. First names ...............................................................................................................................................................

 

4. Address .....................................................................................................................................................................

 

5. Identity/Reference Book No. ....................................................................................................................................

 

6. If you have returned to work, state date.....................................................................................................................

 

7. Address to which cheque should be posted .................................................................................................................


Witness ------------

 

Date----------------------------------------------------------------------------------------------------------------------------------------

Signature of applicant

 

NOTIFICATION OF BIRTH

 

Name of medical practitioner/midwife ..................................................................................................................................

 

Qualifications ---------- .......................................-------    Address ........................................................................................

 

I hereby certify that .............................................................................................................................................................

                                                                            (Name of applicant)

gave birth to a *live/still-born child on .................................................................................................................................

                                                                          (Date of birth of child)

 

Date --------------------------------------------------------- .....      .............................................................................................

                                                                                      Signature of medical practitioner or midwife*

_____________________

* Delete whichever is not applicable.

 

Annexure UF 95

 

DECLARATION BY APPLICANT FOR POST-NATAL MATERNITY BENEFITS

 

To the Claims Officer

Department of Manpower

 

.........................................................................................

 

1. I declare that I have not worked since I was last employed immediately prior to the date of my application for maternity benefits except as shown in item 6 hereunder and that I have not been entitled to, nor have I received, from any employer one third or more of my normal earnings. The information given by me on this form is true and correct and I am aware of the fact that it is an offence to knowingly make false statements on this form.

 

2. Surname (block letters) .............................................................................................................................................

 

3. First names ...............................................................................................................................................................

 

4. Address .....................................................................................................................................................................

 

5. Identity/Reference Book No. ----------------------------------------- .............................................................................

 

6. If you have returned to work, state date ....................................................................................................................

 

7. Address to which cheque should be posted...................................................................................................................

 

8. I gave birth to a *live/still-born child on ...................................................................................................................

 

Witness ................................................................................

 

Date -------------------------------------------------------------------------------------------------------------------------------------------------------------                                                                                                                              ..................................................................................

                                                                                             Signature of applicant

 

______________________

         * Delete whichever is not applicable.

 

Annexure UF 103

 

UNEMPLOYMENT REGISTER/COMPUTATION SHEET (SECTION 35)

 

UF Serial No. .......................................................................................................................................................................

 

Identity/Reference Book No. ...............................................................................................................................................

 

Name ...................................................................................................................................................................................

 

Address ................................................................................................................................................................................

 

Race -------------------------------------------------------------------------    Sex -----------------------------------------------------

 

Married or single -----------------------------------------------------------    Date of birth ------------------------------------------

 

Trade or occupation .............................................................................................................................................................

 

Date of application --------------------------------------------------------    Office --------------------------------------------------

 

      I declare that I am unemployed and have not been employed since I last signed this register and that I have not received remuneration for any work performed without notifying the claims officer.

 

I am aware of the fact that it is an offence to sign the register while I am in employment.

 

Date ---------------------------------------------------------------------     --------------------------------------------------------------

                                                                                               Signature of contributor

 

Annexure UF 103A

 

UNEMPLOYMENT INSURANCE ACT, 1966 (SECTION 35)

UNEMPLOYMENT REGISTER FOR RURAL BENEFICIARIES

 

UF Serial No. ......................................................................................................................................................................

 

Identity/Reference Book No. ..............................................................................................................................................

 

Surname ..............................................................................................................................................................................

 

Christian names (in full) .....................................................................................................................................................

 

Address  ..............................................................................................................................................................................

 

Date of birth -----------------------------------------------------------   Married or single -------------------------------------------

 

Race --------------------------------------------------------------------   Sex ------------------------------------------------------------

 

Office of the Claims Officer ...............................................................................................................................................

 

     I declare that I am unemployed and have not been employed since I last signed the register and that I have not received remuneration for any work performed without notifying the Claims Officer. I am aware of the fact that it is an offence to sign this register while I am in employment.

 

Date --------------------------------------------------------------------    ---------------------------------------------------------------

                                                                                              Signature of contributor

 

Annexure UF 107

 

[Annexure UF 107 amended by GN R1235 of 17 June 1983.]

 

APPLICATION FOR ISSUE OF A CONTRIBUTORS' RECORD CARD IN TERMS OF REGULATION 8 (3)

 

To The Unemployment Insurance Fund

Laboria Buildings (P.O. Box 1851)

Paul Kruger Street

Pretoria

0001

 

I hereby apply, in terms of regulation 8 (3), for the issue of a Contributor's Record Card in respect of the undermentioned contributor and declare that: *(a) The original has been lost/destroyed; or *(b) to my knowledge a card has not been previously issued to the contributor. The information given by me on this form is to my knowledge true and correct.

 

      I attach a *postal/money order for fifty cents (50c).

 

Date -----------------------------------------------------------------     -------------------------------------------------------------------

                                                                           Signature of applicant. If application is not made by

                                                                           contributor personally state capacity in which application

                                                                           is made.

                                                                                                                                              --------------------------------------------

 

__________________

 

* Delete whichever is not applicable.

 

1. Surname of contributor ..............................................................................................................................................

 

2. Full other names ........................................................................................................................................................

 

3. Maiden name (in case of married woman) ..................................................................................................................

 

4. Identity/Reference Book No.......................................................................................................................................

 

5. Race --------------------------------------    6. Sex ---------------------------------------   7. Date of birth ..........................

 

8. Ordinary rate of earnings ........................................................................................................... (state p.w. or p.m.)

 

9. Present address of applicant .......................................................................................................................................

 

10. Names and addresses of present/previous employers:

 

 

Dates of employment

 

From

To


........................................................................................................................


.....................................


.....................................

........................................................................................................................

.....................................

.....................................

........................................................................................................................

.....................................

.....................................

 

Note.-Proof of employment with at least one employer to be submitted.

 

11. State circumstances leading to the loss or destruction of previous contributor's record card ......................................

 

12. State reason for this application i.e. purpose for which card is required at this stage .................................................

 

Annexure UF 123

 

[Annexure UF 123 amended by GN R1235 of 17 June 1983.]

 

APPLICATION FOR BENEFITS IN TERMS OF SECTION 35

 

To the Claims Officer

Department of Manpower

 

.............................................................................................................................................................................................

 

1. I hereby apply for unemployment benefits in terms of section 35 of the Unemployment Insurance Act, 1966, and declare that I am unemployed and that the information given by me in this form is true and correct in every respect. I am aware of the fact that it is an offence to make a false statement on this form.

 

2. Surname (in block letters) ----------------------------------------------    3. Christian names .................................................

 

4. Address ----------------------------------------------------------------------    5. Identity/Reference Book No...........................

 

6. Race ------------------------------------------    7. Sex -----------------------    8. Date of birth ..............................................

 

9. Trade or occupation -------------------------------------------------------------    10. Married or single ...................................

 

11. Details of employment:

 

Name of
employer

Address of
employer

Employed as
contributor

Employed as
non-contributor

*Earnings

*Value of free
food and/or
quarters

*Other allowances
(specify nature
and amount)

Reason for
termination of
employment

From

To

From

To

 


....................


......................................


................


................


................


................


........................


...........................


.................................


............................

....................

......................................

................

................

................

................

........................

...........................

.................................

............................

....................

......................................

................

................

................

................

........................

...........................

.................................

............................

 

* Indicate p.w. or p.m.

 

12. Have you ever applied for unemployment/maternity/illness benefits: (Yes or No) ..................................................

 

If so state: (a) Office -------------    (b) Date applied ----------------   (c) UF Serial No -----------------    (d) Name under which applied .....................................

 

13. If last employer paid wages in lieu of notice, state period: From -------------------------   to .....................................

 

14. Are you capable of and available for work? (Yes or No) ..........................................................................................

 

Date -----------------------------------------------------------------      ........................................................................................

                                                                                                Signature of applicant

 

Annexure UF 125

 

UF Serial No.

 

 

 

 

 

 

 

 

 

The Claims Officer

Department of Manpower

 

.........................................................................

 

UNEMPLOYMENT INSURANCE ACT, 1966

 

STATEMENT IN RESPECT OF PAYMENTS MADE TO THE UNDERMENTIONED CONTRIBUTOR WHO IS STILL IN MY EMPLOYMENT BUT IS UNABLE TO WORK DUE TO ILLNESS OR PREGNANCY

 

(A) In terms of section 33 (3) of the above-mentioned Act I forward herewith the contributor's record card (UF 74) of the undermentioned contributor and hereby certify that since ................................ (date in full) the contributor has received from me less than one third of his/her normal remuneration and will not, during the remainder of the period of absence due to illness or pregnancy, receive from me one third or more of his/her normal remuneration.

 

(B) The contributor is expected to return to work on ---------------------------  /the contributor resumed duty on .................

 

Date ----------------------------------------------------------------       ........................................................................................

                                                                                 Signature of employer or duly authorised agent

 

Full names of contributor .....................................................................................................................................................

 

Identity No./Reference Book No. .........................................................................................................................................

 

Annexure UF 126

 

[Annexure UF 126 amended by GN R2412 of 30 October 1987, by GN R2667of 4 December 1987 and by GN R1884 of 9 August 1991.]

 

BETALING AAN AFHANKLIKE VAN AFGESTORWE BYDRAER

PAYMENT TO DEPENDANT OF DECEASED CONTRIBUTOR

AANSOEK DEUR WEDUWEE OF WEWENAAR

APPLICATION BY WIDOW OR WIDOWER

 

Aan die Afdelingsinspekteur   Departernent van Mannekrag/To the Divisional Inspector   Department of Manpower

 

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Hierby doen ek aansoek om betaling ingevolge artikel 38 van die Werkloosheidversekeringswet, 1966, en verklaar ek dat ek die enigste weduwee/een van . . . . . weduwees/wewenaar* van ondergenoemde afgestorwe bydraer is, dat ek nie van hom/haar* geskei was nie en dat die inligting wat ek op hierdie vorm verstrek, juis en korrek is.

I hereby apply for a payment in terms of section 38 of the Unemployment Insurance Act, 1966, and declare that I am the only widow/one of . . . . .       widows/widower* of the undermentioned deceased contributor, that I was not divorced from him/her* and that the information given by me in this form is true and correct.

 

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      Datum/Date                             Handtekening van weduwee/wewenaar*/Signature of widow/widower*

 

*  Skrap wat nie van toepassing is nie. / Delete whichever is not applicable.

 

 

A. Moet deur die applikant ingevul word:/To be filled in by applicant:

1.  Volle naam van applikant (blokletters)/Full name of applicant (block letters)

 

                                                                                                                                              --------------------------------------------------------------------------------------------

 

2.  Adres/Address -------------------------------------------------------------------------------------------------------------------------

 

                                                                                                                                              --------------------------------------------------------------------------------------------

 

3.  Persoons-/Identiteits-/Bewysboeknommer van applikant

    Identity/Reference book number of applicant -------------------------------------------------------------------------------------

 

4.  Volle naam van afgestorwe bydraer (blokletters)/Full name of deceased contributor (blockletters)

 

                                                                                                                                              --------------------------------------------------------------------------------------------

5.  Laaste woonadres van afgestorwe bydraer/Last residential address of deceased contributor

 

                                                                                                                                              --------------------------------------------------------------------------------------------

6.  Persoons/Identiteits-/Bewysboeknommer van afgestorwe bydraer/Identity/Reference book number of deceased contributor

 

                                                                                                                                              --------------------------------------------------------------------------------------------

 

7.  Datum van oorlyde/Date of death --------------------------------------------------------------------------------------------------

 

 

C.  Dokumente wat aangeheg moet word:    Documents to be attached:

 

1.  Bydraersverslagkaart van die afgestorwe bydraer/Contributor's record card of the deceased contributor.

2.  Die doodsertifikaat, die lykskouingsertifikaat, of die begrafnisorder wat op die dood van sodanige bydraer betrekking het.

The death certificate, post-mortem certificate or burial order relating to the death of such contributor.

3.  Sertifikaat in die vorm van U F 128 van sy/haar laaste werkgewer.

Certificate from his/her last employer in the form of U F 128.

4.  Huweliksertifikaat/Marriage certificate

 

OPMERKINGS -
NOTES -

(i)

As daar in die geval van 'n weduwee of 'n wewenaar geen huweliksertifikaat bestaan wat ingevolge enige wet wat in die Republiek van Suid-Afrika van krag is en op huwelike betrekking het, as geldig erken word nie, moet 'n volledige verklaring betreffende die omstandighede van die saak aangeheg word.

 

In the case of a widow or widower, if there is no marriage certificate recognised as valid in terms of any law relating to marriage in force in the Republic of South Africa, a full statement regarding the circumstances of the matter should be attached.

 

 

SLEGS VIR AMPTELIKE GEBRUIK/FOR OFFICIAL USE ONLY.

 

Gesertifiseer dat die ondersteunende (vermeld dokumente)/Certified that supporting (describe documents) --------------------

 

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wat die betrokke name en datums hierop bevestig, aan my getoon is/confirming relevant names and dates hereon were produced to me.

 

Datum/Date ---------------------------   Handtekening/Signature ------------------------  Rang/Rank -------------------------------

 

Annexure UF 127

 

[Annexure UF 127 amended by GN R1235 of 17 June 1983, by GN R2412 of 30 October 1987 and by GN R2667of 4 December 1987.]

 

PAYMENT TO DEPENDANTS OF DECEASED CONTRIBUTOR

APPLICATION BY PERSON OTHER THAN WIDOW/WIDOWER

 

To the Divisional inspector, Department of Manpower .......................................................................................................

 

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I hereby apply for a payment in terms of section 38 of the Unemployment Insurance Act, 1966, and declare that the information given below is true and correct to the best of my knowledge and belief.

 

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           Date                                                                                                                         Signature of Applicant

 

 

 

A. TO BE FILLED IN BY APPLICANT:

 

   1. FULL NAME OF APPLICANT (block letters) --------------------------------------------------------------------------------

 

                                                                                                                                             

 

   2. STATE WHETHER MR., MRS, OR MISS --------------------------------------------------------------------------------------

 

   3. ADDRESS --------------------------------------------------------------------------------------------------------------------------

 

   4. IDENTITY/REFERENCE BOOK NUMBER OF APPLICANT --------------------------------------------------------------

 

   5. FULL NAME OF DECEASED CONTRIBUTOR (block letters) -------------------------------------------------------------

 

                                                                                                                                             

 

   6. LAST RESIDENTIAL ADDRESS OF DECEASED CONTRIBUTOR -------------------------------------------------------

 

                                                                                                                                             

 

   7. IDENTITY/REFERENCE BOOK NUMBER OF DECEASED CONTRIBUTOR -------------------------------------------

 

   8. DATE OF DEATH ----------------------------------------------------------------------------------------------------------------

 

   9. RELATIONSHIP (if any) OF APPLICANT TO DECEASED CONTRIBUTOR -------------------------------------------

 

                                                                                                                                             

 

  10. IF APPLICATION MADE FOR THE BENEFIT OF A PERSON OTHER THAN THE APPLICANT STATE:

 

            (a)     Full name of such person (block letters) ----------------------------------------------------------------------------

 

            (b)     Address -----------------------------------------------------------------------------------------------------------------

                  

                                                                                                                                              ----------------------------------------------------------------------------------

 

            (c)     Relationship of such person to deceased contributor --------------------------------------------------------------

 

            (d)     Where application is made on behalf of a child under the age of 17 years at the date of death of deceased contributor, give full names and addresses of any other children, including any adopted children of deceased contributor under 17 years of age at the date of death of deceased contributor.

 

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B. DOCUMENTS TO BE ATTACHED:

 

    I attach hereto:

 

    1.  Contributor's record card of the deceased contributor;

    2.  The death certificate, post mortem certificate or burial order relating to the death of such contributor;

    3.  In the case of an application on behalf of a child or children, including any adopted children, under the age of 17 years at the date of death of the deceased contributor, the birth certificate(s) of such Child or children;

    4.  Certificate from the last employer of the deceased contributor in the form of U.F. 128;

    5.  An affidavit giving reasons why payment should be made to me.

 

 

NOTES:

 

  (i)    The affidavit should give the full grounds upon which the application is based and include a declaration in regard to the person for whose benefit the payment is claimed, stating -

        (a)  whether such person was wholly or mainly dependent on the deceased contributor for the necessities of life, and

        (b)  the amount and sources of all income of such person as at the date of death of the deceased contributor.

 

(ii)    Where the applicant, or the person, on whose behalf application is made, is in receipt of a grant from the Department of Health, Welfare and Pensions or other State Department or is being cared for in an institution, particulars of the grant or the name of the institution should be given.

 

 

FOR OFFICIAL USE ONLY.

 

Certified that supporting (describe documents) ---------------------------------------------------------------------------------------

------------------------------------------------------------------------------ confirming relevant

names and dates hereon were produced to me.

 

Date ---------------------------------------------                          Signature -----------------------------------------------------------

 

                                                                       Rank ---------------------------------------------------------------

 

Annexure UF 128

 

PAYMENTS TO DEPENDANTS OF DECEASED CONTRIBUTOR

 

FORM TO BE COMPLETED BY EMPLOYER IN RESPECT OF DECEASED CONTRIBUTOR

 

Note.-An employer who employed the deceased contributor must complete the form on request and thereafter return it to the person who requested its completion.

 

Name of employer ...............................................................................................................................................................

 

Address of employer.............................................................................................................................................................

 

Employer's UIF Registration No. .........................................................................................................................................

 

I forward herewith, as required by regulation 13 (3) under the Unemployment Insurance Act, 1966, the contributor's record card of the undermentioned deceased contributor, and certify that the following information in respect of such contributor is true and correct.

 

1. Full names of deceased contributor (block letters) .....................................................................................................

 

2. Identity/Reference Book No. of deceased contributor ...............................................................................................

 

3. Period(s) in my employ as a contributor (any change in earnings to be indicated):

 

From

To

Earnings (including payment in kind)

Weekly

Monthly

 


............................................................


..................................................


.............................


.............................

............................................................

..................................................

.............................

.............................

............................................................

..................................................

.............................

.............................

 

4. If during period(s) mentioned in 3 above no contributions were paid, state:

 

From

To

Reasons for not contributing


............................................................


..................................................


............................................................

............................................................

..................................................

............................................................

............................................................

..................................................

............................................................

 

                                                                                                                                              ----------------------------------------

Signature of employer

 

Date ------------

 

Annexure UF 139

 

APPLICATION FOR FURTHER BENEFITS IN TERMS OF SECTION 35 (14)

 

The Claims Officer

Department of Manpower...................................................

-

 

1. I hereby apply for the payment of further benefits in terms of section 35 (14) of the Unemployment Insurance Act, 1966, and declare that I am unemployed and that the information given by me in this form is true and correct in every respect. I am aware of the fact that it is an offence to make a false statement in this form.

 

2. Surname (in block letters) -------------------------------------    3. First names ---------------------------------------------------

 

4. Address ----------------------------------------------------------    5. Identity/Reference Book No.--------------------------------

 

6. Race ------------------------------------------    7. Sex -------------------------------------    8. Date of birth ---------------------

 

9. Trade or occupation -------------------------------------------    10. Married or single -------------------------------------------

 

11. Details of employment:

 

Name of
employer

Address of
employer

Employed as
contributor

Employed as
non-contributor

Earnings

*Value of
food and/or
quarters

*Other allowances
(specify nature
and amount)

Reason for
termination of
employment

From

To

From

To

 


....................


......................................


................


................


................


................


........................


...........................


.................................


............................

....................

......................................

................

................

................

................

........................

...........................

.................................

............................

....................

......................................

................

................

................

................

........................

...........................

.................................

............................

 

* Indicate per week or per month.

 

12. Are you capable of and available for work? (Yes/No)...............................................................................................

 

I have made efforts, details of which are given hereunder to obtain employment, but have been unsuccessful for the reasons indicated in the space provided below.

 

           Full details of efforts made to find employment                                           Reasons why not successful

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                                                                                                      Signature of applicant

Date -----------------------------------------------------------------------------------------------

 

Annexure UF 140

 

[Annexure UF 140 amended by GN R960 of 20 May 1988 and by GN R1976 of 22 October 1993.]

 

 


UNDER CONSTRUCTION