Rehabilitation Assessment Form

ENSURE THAT YOU READ OUR FREQUENTLY ASKED QUESTIONS “FAQ’S” FOR REHABILITATION BEFORE COMPLETING THE ASSESSMENT / REHABILITATION APPLICATION”

This assessment form may be completed and sent to us should you wish to start with your rehabilitation process / application. If you read the FAQ’s you would have noted that there is some work to be done before we would be in a position to advise whether you may now already apply and whether your unique position qualifies to Apply for Rehabilitation and whether Contribution is payable. Our fee for this is, R 1, 725-00 (Incl.) Once done we will advise exactly if not immediately when you can Rehabilitate. When instructed to proceed with the Court application R 15,095-00 is payable (all-inclusive fee & disbursements etc.). Application takes approximately 7 weeks.

Should you wish to proceed with assessment, complete undermentioned information, deposit R 1,725-00 in bank account and email to rishay@uysincorp.co.za Bank: First National Bank, Branch 251145, Account 6239 2671 113, Reference RH0000/YOUR SURNAME

REHABILITATION – ASSESSMENT

Full names*
ID Number*
Work Number*
Cell Number*
Email Address*
Your Residential Address*
Occupation: (If unemployed, state unemployed)*
Marital Status*
- Unmarried
- Married out of Community
- Married in Community
If married in community of property: Spouses details:
Full names*
Work Number*
Cell Number*
Email Address*
Residential Address*
Occupation: (If unemployed, state unemployed)*
Were You Married at time of Sequestration:*
- Yes
- No
If Yes, to the same person above:
- Yes
- No
Date of sequestration*
MM slash DD slash YYYY
Curator’s Name:*
Curator’s Tel:*
Reason for sequestration*
(retrenchment, medical etc.)
- Current own Assets
- 1. Current own Assets
- 2. Current own Assets
- 3. Current own Assets
- 4. Current own Assets
- 5. Current own Assets
- AMOUNT ±
- 1. Current own Assets Amount
- 2. Current own Assets Amount
- 3. Current own Assets Amount
- 4. Current own Assets Amount
- 5. Current own Assets Amount
- Current spouse Assets
- 1. Current spouse Assets
- 2. Current spouse Assets
- 3. Current spouse Assets
- 4. Current spouse Assets
- 5. Current spouse Assets
- AMOUNT ±
- 1. Current spouse Assets Amount
- 2. Current spouse Assets Amount
- 3. Current spouse Assets Amount
- 4. Current spouse Assets Amount
- 5. Current spouse Assets Amount
Own & Spouse current income and Expenses:
- TOTAL INCOME
- Salary (Own)
- Salary (Spouse)
- Other Income(Own)
- Other Income Spouse)
- AMOUNT ±
- Salary (Own)
- Salary (Spouse)
- Other Income(Own)
- Other Income (Spouse)
- TOTAL EXPENSES
- Rent / Bond
- Water & Electricity
- Groceries
- Petrol
- Insurance
- School Fees
- Other 1
- Other 2
- Other 3
- Other 4
- AMOUNT ±
- Rent / Bond
- Water & Electricity
- Groceries
- Petrol
- Insurance
- School Fees
- Other 1
- Other 2
- Other 3
- Other 4
NOTE: If there are any Queries please do not hesitate to call us !!

Rehabilitation Assessment Form - FREE SERVICE

REHABILITATION – ASSESSMENT

If married in community of property: Spouses details:

Current own Assets

AMOUNT ±

Current spouse Assets

AMOUNT ±

TOTAL INCOME

AMOUNT ±

TOTAL EXPENSES

AMOUNT ±

How can we assist

Let Francois Uys Attorneys assess your unique situation.

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Personal Sequestration starting from R10,000.