Close Corporation Special Power of Attorney form
The original document MUST be filled in in black ink and posted or delivered to us.
Special Power of Attorney

I / We the undersigned .........................................................................................................do hereby nominate,constitute and appoint

Leon Delport of the firm Delport van den Berg Attorneys, Johannes Marthinus Oelofse and/or
Hennie Oelofse and/or Melissa Gerber

to register on my / our behalf a Close Corporation with the name

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

or any other name that the Registrar of Close Corporations may approve, to determine my member's interest and

contribution, to sign forms CK1 and to do anything necessary or expedient to the registration of the Close Corporation.

Signed at (City): ..................................................... this (Date): ........................... day of (Month): .............................................. 200.....


1. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
2. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
3. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
4. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
5. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
6. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
7. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
8. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
9. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
10. ) Full Names: .......................................................................................................................................................................................................
I.D. No:                           Signature .........................................................................................................
 
 
NB: Please ensure that this document is filled in by the members themselves, filled in black ink and the original returned to us.
(Only the members themselves are allowed to sign this document.)
 

Business Registration Warehouse
209 van der Hoff Road
Pretoria Gardens x 3

Tel: (012) 379 1804
Fax: (012) 379 7961

P.O. Box 48444
Hercules
0030