Attached Hereto Is a Fully Completed Screening Questionnaire (DD 1057) in Respect of The

CONTRACTORS

TO: THE MANAGER
ARMSCOR PERSONNEL EVALUATION
DIVISION (APED)
ARMSCOR
PRIVATE BAG X337
PRETORIA
0001
ENQUIRIES: (012) 428-3546 / FROM (Co. Name):
CONTACT PERSON:
TEL:

Attached hereto is a fully completed Screening Questionnaire (DD 1057) in respect of the following person:

1.  APPLICANT'S PARTICULARS

INITIALS AND SURNAME
IDENTITY NUMBER
NAME OF COMPANY EMPLOYED BY

2.  CLEARANCE LEVEL REQUIRED 3. PAYMENT (Tick to indicate preference)

Top Secret Clearance / Payment for the sum of
*R + VAT = R
to the Senior Manager: Financial Accounting, Armscor, Private Bag X337, Pretoria, 0001, is made or will be made by:
3.1 Cheque made out to Armscor
or
Electronic Transfer
Absa Bank, Menlyn, Pretoria, Account No. 2310143807
Branch code no 335645. Quote name of firm and
Invoice no. or applicant’s name
3.2 Payment accompanying clearance application
or
Payment within 30 days of receipt of invoice
after clearance outcome
Clearance cost to be recovered from:
Company:______
Postal address: ______
______
COMPANY VAT REG NO.: ______
*Current clearance tariff shall apply and is obtainable from
APED.
* / Secret Clearance
Confidential Clearance
EXPRESS SERVICE (higher tariff)
/ Deadline date:
* / Minimum vetting requirement for Immigrants and Dual citizens
MOTIVATING COMMENT
(Project name essential if applicable)
4. AUTHORISATION
General conditions of payment:
- A tax invoice will be issued.
- For prospective contractors, payment shall
accompany application.
- No refunds for cancellation of application will
be made, once the vetting investigation has
started.
SIGNATURE
- Abovementioned company accepts respon-
sibility for the clearance fee even if the clear-
ance is not awarded due to any reason what-
soever, or the applicant resigns from the
employ of the company before the clearance
is finalized.
G:\USERS\AMANDAZ\WINDOC\WORD\Cost_Contractors4.doc
NAME OF DULY AUTHORISED MANAGER (PRINT)
DATE