DW811

PROPERTY AMENDMENT
/

SALE OF PROPERTY

Register Number / 
1. REGISTERED PROPERTY
Property where water use takes place (farm, stand or community)
a) Surveyor-General office
b) / administrative district / or / registration division
c) farm number / d) portion of property
e) Transfer of title number (existing owner) / f) title deed date
T / Y / Y / Y / Y / M / M / D / D
g) Transfer of title number (amended: new owner) / h) title deed date
T / Y / Y / Y / Y / M / M / D / D
2. DETAILS OF THE REGISTERED PROPERTY OWNER (SELLER)
2.1 / Nature of the property owner (mark only one)
Person / Company* / National Government / Provincial Government / Other
Description of other
2.2 / Identification number (if applicable) / (e.g. id number, business register number)
Country of issue of identification if a foreign id. / Expiry date
2.3 / Surname or name of property owner
2.4 / Initials (if applicable) / Title (if applicable)
2.5 / If the property owner is a company*:
Trading name if applicable and different from name of company, business or partnership
Date established / Y / Y / Y / Y / M / M / D / D
Country where established
2.6 / Postal address
Postcode
2.7 / Street address (only if different from postal address)
2.8 / Contact telephone number during office hours
area/cell code / number / ext.
* public company, private company, company not for gain, guarantee company, external company, incorporated private company, closed corporation

Department of Water & Sanitation (Version 1, 23 March 2015)Property Amendment /Sale of Property

DW811

3. DETAILS OF THE AMENDED PROPERTY OWNER (BUYER)
3.1 / Nature of the property owner (mark only one)
Person / Company* / National Government / Provincial Government / Other
Description of other
3.2 / Identification number (if applicable) / (e.g. id number, business register number)
Country of issue of identification if a foreign id. / Expiry date
3.3 / Surname or name of property owner
3.4 / Initials (if applicable) / Title (if applicable)
3.5 / If the property owner is a company*:
Trading name if applicable and different from name of company, business or partnership
Date established / Y / Y / Y / Y / M / M / D / D
Country where established
3.6 / Postal address
Postcode
3.7 / Street address (only if different from postal address)
3.8 / Contact telephone number during office hours
area/cell code / number / ext.
* public company, private company, company not for gain, guarantee company, external company, incorporated private company, closed corporation
4. DECLARATION BY APPLICANT
4.1 / Surname of registered * / delegated * person (* delete whichever is not applicable)
initials / title / ID number
4.2 / Position or official status
4.3 / Contact telephone number during office hours
area/cell code / number / ext.
4.4 / I declare that the information given by me is true and correct.
signature / date
thumbprint
Y / Y / Y / Y / M / M / D / D / (only if
requested)

FOR OFFICIAL USE ONLY

File number
Received by:
Surname / Initials
Rank
Signature
Captured by:
Initials

Date stamp of receiving office

Department of Water & Sanitation (Version 1, 23 March 2015)Page 1 of 3