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Client Surname & Initial(s) Tel no E-mail address
Proof of payment : Payment to be made to the following account :
RCH Legal Cheque Account
FNB George
Acc no : 62474621177
Branch code : 210114
DOCUMENTS TO BE ATTACHED
_________________________________________________________________________
ID: Copy of ID documents
Certificates : Copy of marriage certificate and birth certificates of minor children
Statistics form Completed statistics form
Annexure A : Only where minor children are involved
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DIVORCE QUESTIONAIRE
1.
The Plaintiff is
with residential address at and
work address at
2.
The Defendant is with
residential address at and
work address at
3.
The parties hereto were married in / out of community of property with/without
accrual on and at and this
marriage still subsists. (Kindly attach copy of marriage certificate and
antenuptual contract if any)
4.
From the marriage between the parties child(ren) were born, namely
(names and birth dates) :
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5
It shall be in the best interest of the minor children that the custody and control
be awarded to .
6.
The marriage relationship between the parties has reached such a state of
disintegration, that there exists no reasonable prospect of the restoration of a
normal marriage relationship between them, for the following reasons (please
mark which applicable):
6.1 There is no communication between the parties, and the parties can no
longer get along with each other;
6.2 The defendant is unreasonably jealous towards the plaintiff;
6.3 The defendant unjustly accuses the plaintiff of relationships with third
parties;
6.4 The defendant has started a love relationship with another man/ woman;
6.5 The parties have on several occasions experienced trouble with their
marriage and tried to restore the relationship, without success;
6.6 For the past few years the parties could not adjust to each others needs
and experienced conflict of interest;
6.7 The personalities and the way of living of the parties cannot adjust to each
other, since they follow different occupations;
6.8 The defendant regularly quarrels with the plaintiff’s family in a manner that
is unreasonable and unacceptable to the plaintiff;
6.9 The plaintiff and defendant do not cohabit as husband and wife anymore;
6.10 The defendant is grumpy and quarrelsome towards the plaintiff;
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6.11 There is no meaningful communication between the parties, and they
quarrel regularly;
6.12 The defendant is excessively aggressive towards the child(ren);
6.13 The defendant regularly drinks excessively in front of the plaintiff and their
child(ren);
6.14 The defendant becomes aggressive and violent towards plaintiff and the
child(ren), especially when under the influence;
6.15 The defendant gets fits of fury towards the plaintiff;
6.16 The defendant has assaulted the plaintiff on a previous occasion;
6.17 The defendant has chased the plaintiff away from the common home;
6.18 The Defendant refuses the Plaintiff his/ her marital privileges on a regular
basis;
6.19 There was continuous arguments between the parties on politics, religion
and money;
6.20 The Plaintiff tried to persuade the Defendant to move back into the
common home, to resume the marriage relationship and to attempt
reconciliation. The Defendant refused to co-operate;
6.21 the Defendant became physically cold and aloof towards the Plaintiff;
6.22 The Plaintiff has lost his love, respect and affection for the Defendant;
6.23 The parties are no longer interested in the continuation of the marriage
relationship.
7.
The communal property currently consists out of:
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7.1
The plaintiff is currently in possession of the following movable assets to which
he/ she is not the owner, and to which he/ she has no right of possession:
WHEREFORE the Plaintiff claims:
a. A decree of divorce;
b. Division of the communal property, including division of the defendant’s
pension and policies;
c. An order that the parental rights and duties regarding the daily care of the
minor children, as stipulated in Section 18(2)(a) of The Children’s Act 38
of 2005 (hereinafter called “the Act”), shall vest in the (state party);
d. An order stating that the permanent residence of the minor children shall
vest in the (state party);
e. An order stating that certain parental rights and duties regarding contact
with and access to the minor children, as stipulated in Section 18(2)(b) of
the Act, shall vest in the (state party) as follows: (visits)
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(i)
f. The parental rights and duties with regards to guardianship over the minor
children, as referred to in Section 18(2)(c) and 18(3) of the Act, are
awarded to both parties jointly, which implies that all decisions regarding
the minor children must have both parties’ approval.
g. Maintenance in the amount of monthly per minor
child;
h. Maintenance towards the plaintiff/defendant in the amount of
;
i. An order that the plaintiff is entitled to payment by the defendant of an
amount that is equal to half the difference between the accrual of the
plaintiff and defendant’s estate;
j. Cost of the suit, only if defended;
k. Further and/ or alternative relief.
( * Delete where not applicable) RC19
1
ANNEXURE A
(REGULATION 2 OF THE MEDIATION IN CERTAIN DIVORCE MATTERS REGULATIONS, 1990)
IN THE REGIONAL COURT FOR THE REGIONAL DIVISION OF GAUTENG
HELD AT ____________________ CASE NUMBER: ____________________
IN THE MATTER BETWEEN:-
_________________________________________ PLAINTIFF
Identity Number: ___________________________
AND
__________________________________________ DEFENDANT
Identity Number: ____________________________
ARRANGEMENTS REGARDING DEPENDENT AND MINOR CHILDREN
PARTICULARS OF PLAINTIFF/APPLICANT:
POSTAL ADDRESS: _________________________
_________________________
_________________________
_________________________
RESIDENTIAL ADDRESS: _________________________
_________________________
_________________________
_________________________
TELEPHONE NUMBER: _________________________
NAME AND ADDRESS OF EMPLOYER: _________________________
_________________________
_________________________
_________________________
TELEPHONE NUMBER: _________________________
GROSS MONTHLY INCOME: _________________________
EXTENT OF MONTHLY FINANCIAL COMMITMENTS:
( * Delete where not applicable) RC19
2
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
PARTICULARS OF DEFENDANT/RESPONDENT:
POSTAL ADDRESS: _________________________
_________________________
_________________________
_________________________
RESIDENTIAL ADDRESS: _________________________
_________________________
_________________________
_________________________
TELEPHONE NUMBER: _________________________
NAME AND ADDRESS OF EMPLOYER: _________________________
TELEPHONE NUMBER: _________________________
GROSS MONTHLY INCOME, IF KNOWN: _________________________
EXTENT OF MONTHLY FINANCIAL COMMITMENTS, IF KNOWN:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
GENERAL INFORMATION
STATE THE FULL NAME, GENDER AND DATE OF BIRTH OF EACH MINOR OR DEPENDANT CHILD OF
THE MARRIAGE:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
STATE WITH WHOM THE CHILDREN ARE LIVING AT PRESENT:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
STATE WHERE THE CHILDREN ARE TO LIVE, FURNISH PARTICULARS OF THE ACCOMODATION, WHAT
( * Delete where not applicable) RC19
3
OTHER PERSONS (NAME THEM) ARE LIVING THERE AND WHO WILL LOOK AFTER THE CHILDREN. IF
IT IS PROPOSED THAT THE CHILDREN SHOULD BE IN THE CARE OF ANOTHER PERSON OTHER THAN
YOU, STATE THE RELATIONSHIP OF SUCH OTHER PERSON TO THE CHILDREN?
__________________________________________________________________________________
__________________________________________________________________________________
STATE THE NAME OF THE SCHOOL OR OTHER EDUCATIONAL ESTABLISHMENT WHICH YOUR
CHILDREN ARE AT PRESENT ATTENDING, OR, IF ANY OF THEM ARE ALREADY WORKING, THEIR PLACE
OF EMPLOYMENT, THE NATURE OF THEIR WORK AND DETAILS OF ANY TRAINING THEY ARE
RECEIVING, ATTACH COPIES OF THE MOST RECENT SCHOOL REPORTS:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
IS IT ENVISAGED THAT THE CHILDREN, AFTER THE CONCLUSION OF THE ACTION/ APPLICATION, WILL
HAVE TO CHANGE SCHOOLS? IF SO, GIVE FULL DETAILS:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
DO ANY OF THE CHILDREN EXPERIENCE LEARNING PROBLEMS? ARE ANY OF THEM IN ANY RESPECT
PHYSICALLY OR MENTALLY DISABLED? IF SO, GIVE FULL DETAILS AND ATTACH RECENT MEDICAL
REPORTS.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
STATE WHO IS SUPPORTING THE CHILDREN AT PRESENT, OR CONTRIBUTING TO THEIR SUPPORT,
AND TO WHAT EXTENT?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
( * Delete where not applicable) RC19
4
WHAT ARRANGEMENTS HAVE BEEN MADE REGARDING RIGHTS OF ACCESS OF YOUR
HUSBAND/WIFE? STATE THE DETAILS OF ANY SUCH ARRANGEMENT?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
SET OUT ANY FURTHER DETAILS CONCERNING YOUR MINOR OR DEPENDANT CHILDREN WHICH MAY
BE RELEVANT TO THE CUSTODY OF, ACCESS TO AND FINANCIAL PROVISION FOR SUCH CHILDREN,
E.G. WHETHER ANY SUCH CHILDREN HAVE BEEN CONVICTED OF ANY CRIMINAL OFFENCE WHETHER
ANY SUCH CHILDREN HAVE BEEN SUBJECT TO ANY ORDER IN TERMS OF THE CHILD ACT, 1983 (ACT
NO 74 OF 1983):
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
STATE BRIEFLY THE EXTENT TO WHICH THE ABOVE ARRANGEMENTS REGARDING YOUR MINOR OR
DEPENDANT CHILDREN ARE THE RESULT OF MUTUAL AGREEMANT WITH YOUR
HUSBAND/WIFE/SPOUSE?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
ARE YOU OR A MEMBER OF YOUR FAMILY KNOWN TO A WELFARE ORGANISATION OR AGENCY? IF
SO, STATE THE NAME OF THE ORGANISATION/AGENCY AND WHERE IT OPERATES.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
I, __________________________________ HEREBY DECLARE UNDER OATH/HEREBY TRULY AFFIRM
THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE FOREGOING STATEMENTS ARE TRUE,
COMPLETE AND CORRECT.
( * Delete where not applicable) RC19
5
DATED AT ____________________ THIS _______ DAY OF ____________________ 20______.
____________________________________
SIGNED
I certify that, before administering the oath/affirmation*, I asked the deponent the following
questions and wrote his/her answers in his/her presence:
1. Do you know and understand the contents of the above declaration?
Answer: ________________________________
2. Do you have any objection to taking the prescribed oath?
Answer: ________________________________
3. Do you consider the prescribed oath to be binding on your conscience?
Answer: ________________________________
I certify that the deponent has acknowledged that he/she* knows and understands the contents of
this declaration which was sworn to/affirmed before* me, and the deponent’s signature/thumb
print/mark* was placed thereon in my presence.
_________________________________________________
JUSTICE OF THE PEACE/COMMISSIONER OF OATHS*
FULL NAME:
SURNAME:
BUSINESS ADDRESS:
DATE:
STATISTICS OF DIVORCES CASE NO. FORM 07-04 EXPLANATORY NOTES: Implementation date: 03/05/99 SECTIONS 1 - 4 TO BE COMPLETED FOR BOTH HUSBAND AND WIFE. SECTIONS 5 - 10 TO BE COMPLETED BY THE PLAINTIFF.
Husband Wife 1. IDENTITY 1.1 Name and surname 1.2 Current address (or last known address) 1.3 Identity number
1.4 Population group1 1.5 Occupation at time of divorce 1.6 Plaintiff 1
……………………………………………………….……… ……………………………………………………….……… ……………………………………………………….……… African/Black Coloured Indian/Asian White Other (Specify):…………………...…………………. ……………………………………………………………... Husband
……………………………………………………….……… ……………………………………………………….……… ……………………………………………………….……… African/Black Coloured Indian/Asian White Other (Specify):……………..………………..……. ………………………………………………….…………. Wife
2. MARITAL STATUS AT TIME
OF MARRIAGE 1
Never Widower Divorcee Married married
Never Widow Divorcee married
3. NUMBER OF TIMES MARRIED (including current marriage)
4. AGE AT TIME OF DIVORCE
APPLICATION
5. DATE OF SEPARATION
Day Month Year
6. PRESENT MARRIAGE
SOLEMNIZED 1
Church Dept of Home Affairs Magistrate's office Mosque Synagogue C Customary rites Other religious buildings Other
7. MATRIMONIAL PROPERTY
SYSTEM 1
In community of property Out of community of property Out of community of property (excluding accrual system) Out of community of property (including accrual system) Other(Specify):……………...………………..….
8. NUMBER OF MINOR
CHILDREN INVOLVED
9. AGE AND GENDER OF MINOR CHILDREN INVOLVED (under 18 years) 1 = Male 2 = Female
Age Gender Age Gender Age Gender Age Gender Child 1 Child 3 Child 5 Child 7 Child 2 Child 4 Child 6 Child 8
10. DATE OF MARRIAGE
Day Month Year
NB SECTIONS 11 - 12 TO BE COMPLETED BY THE REGISTRAR 11. DATE OF DIVORCE
Day Month Year
12. HIGH COURT/FAMILY COURT
……………………………………………………………………………… 1 Mark applicable block with a cross (x) REGISTRAR.: ………………………..…………………….……. Note: Copies of this form can be obtained from: Directorate of Vital Statistics, Statistics South Africa, Private Bag X44, Pretoria 0001. The Afrikaans version is at the back. Copies of the form in the other official languages would be sent upon request. If children are more than eight (8) please fill in another form and attach it to this one.