UNEMPLOYMENT INSURANCE ACT 63 OF 2001 un mployers Declaration of Employees for the month of March 2020) ied in terms of Section S6(14&3) read wi 13(182) ner af any vice. The employer must forward The completed form ean also be faxed to any ‘Ldn (043) 701 3263; Buta (051) 447 9383: C 8024; 4h (013) 636 0233:PE ( (033) 394 5069; 1. EMPLOYEI 1 UIF Employer Reference No [2] 2] 4] 5] 9f 2] 3] Branch No 12. PAYE Reference No (If registered with SARS) [7] 1] 8]o][7 [8] 6[3]2 © 1.3 Trading name of business _Renelex LA Physical Address _6 Pax Stee, Sidwell, 115. Address where employees listed in lem 2 work (if different tothe address in 4) 1.6 Postal address 22 Handsworth Street, Glen Hurd, Port Elizabeth, 6045 17 Co,Regnociprono) [2] 0] 0] 9]/ Jol t[o]3[o]7]/[o]7 address _tax@dirknyburgh.coza 1.9 Fax No (086 559 3713 [1 1Authorised person®™ 2._EMPLOYEE DETAILS. Surname wosaner TotaiGro MURPHY 1, Detlef Romatzki, ID 6204135072082, dec! EMPLOYER SIGNATURE, ev FensUNEMPLOYMEN’ \SURANCE ACT 63 OF 2001, uy I Employers Deslaration of Emplayes forthe month of hes cin terms of Section (183) rend with Regulation 13143) Ta cap pe RN TORR TTT repr (035) 394 5069; Kimberley (053) 852 7218 1, EMPLOYER DETAILS LL UIF Employer Reference No [ 2] 2 jn oF service, The employ ‘completed 143) 701 3263; Blftn (051) 447 9353; CT (O21) 481 $024, Wt (03) 656 0253:PE (O41) 586 LSA DEDE Torn tothe Unemployment Insurance F the following numbers: Pea (012) 309 5142/5286, alo be faxed to any ib (011) 497 3293; Don (031) 366 2156; Polokwane (015) 290 smn (011) 833 2219;George (O44) 873-2568; Pb Branch No 1.2. PAYE Reference No (If registered with SARS) [7] 1] 8 [0 ‘1.3 Trading name of business _Renelex LA Physical Address _6 Pax Set Sidwell, Port Elizabeth, 6001 1.5 Address where employees listed in Kem 2 work (if different to the adress in 1A) 1.6 Postal address 22 Handsworth Steet, Glen Hurd, Port Elizabeth, 6045 1.7 Co.Regnociprono) [2] of 0] 9]/ ofr fofs[o]7]/fo[7 1.8 Esmall address _tax@dirkmyburgh.co.2a 1.9 FaxNo _086 5593713 1.10 Phone No 1.1 Authorised person** 2._ EMPLOYEE DETAILS » @ 7 7 7 sirae ie 10Nanber Ferminaton Date (13 Dinos S810 No) JACOBS TR [si zlolifolols{r{olz/o/s| s} roo | oo | 'hS |i | a}ols| ilo NES 1, Detlef Ron 6204135072082, decKGe that pre Bpove information is true and correct. | understand that itis an offence to make a false statement, EMPLOYER SIGNATURE iINSURANCE ACT 63 OF 2001 ee a Employers Declaration of Employees for the month of March 2020 Information to be supplied in terms of Section S6(1.£3) read with Regulation ‘completed form can also be faxed to any othe following numbers: Pua (012) 309 $14215286; Jmb (011) 497 3295; Dh (031) 366 2156; Pe 1670; Mmmabatho (018) 384 2658, East Ldn (043) 701 3263: biftm (051) 447 9353; CT (021) 441 8024:Wtb (013) 656 0233;PE (O41) $86 1541:Gm (053) 394 5069; Kimberley (053) 832 7218. EMPLOYER DETAILS 1) 873 2219;George (144) 873 2568; Pb skwane (015) 250) UP EmplyerRetrenceno BLAS} [5 12. PAVE Reftence No treed win sans) [FTP] 8]0]7 [8] 6[3]2 ame otbusiness Rene 1A Physical Adress _6 Pa Ste Seve Pox Ea 0 13. Ades where employees sted in em 2 work GF aifvent oWewes T@) 16 Pos adiess “22 Hanlavor Sue, Glew Hurd, Pow Hizb 4S 1.7 Co, Reg.No (CIPRO No) 2] 0}0 ffol7 | Emailed “ax@diigbughcoza 19 FixNo 0865393713 1.10 Phone No 2._EMPLOVEE DETAILS premise sr ‘SAMPSON. s{slolajilsislilol2|ols| 3} os | 20} 425 Jolololelile YES. nis true and correct. | understand that itis an offence to make a false statement, DATE __ 04/05/2020 sus mewunflUNEMPLOYMENT INSURANCE ACT 63 OF 2001 :mployees for the month of ‘March 2020) ‘supplied in terms of Section 56(183) read with Regulation 13(182) ‘seventh diy oF each atoat Commissioner oF any cl previous month regarding he employers contact deals or enplayecsremane ion of service. ‘The emplasce must forward surance Fund at (012) 33 ployer. The eompleted fom can also be Faxed to a 2 (012) 309 5142/5286: 1670; Manubatho (018) 384 2658; East Ldm (043) 101 3263; Blfen (051) 447 9353; CT (O21) 441 8024.WWub (013) 656 O233:PE (041) 586 (03395 Kimberley (053) 832 7218. EMPLOYER DETAILS LL UIF Employer Reference No [ 2] 2] 4] 5] 9] Branch No ‘Trading name of business _Renelex 1A Physical Address _6 Pax Steet, Sidwell 1.2. PAYE Reference No (I'registered with sans) [71 [8 ]o[7[s[o]3 zat, 6001 LS Address where employees listed in tem 2 work (if different to the address in 14) 1.6. Postal address 22 Handsworth Street, Glen Hurd, Port Elizabeth, 6045 7 Co.RegnocciproNne) [2[ oo] 9]/ [oli fofs[ofz[/fo]7 L8 E-mail address _tax@dirkmyburgh co.za 1.9 FaxNo 086 5593713 1.10 Phone No LL Authorised person’* 2,_EMPLOYEE DETAILS JACOBS tation is true and correct. | understand that it is an offence to make a false statement D 6204 |, Detlef Romatzki EMPLOYER SIGNATURE, DATE ___ 04/05/2020,my NCE ACT 63 OF 2001 March 2020) Fund at ( 12) 309 5142/5286, (018) 384 2658: East Lan (043) 701 5263; Blftn (051) 447 9355; CT (021) 441 8024;Wth (013) 656 0233)PE (O41 586 1 (033) 394 5069; ey (053) 832 7218, 1, EMPLOYER DETAILS 497 3295; Db (5 (ony 873 2219 ge (M4) 873 2568; Pea LLL UIF Employer Reference No PAYE Reference No (if registered with ars) [7] 1] 8 ]0]7]8]6[3[2 name of business Physical Address _6 Pax Steet, Sidwell. Port Elizabeth, 6001 re employees liste Postal address 22 Handsworth Street, Glen Hurd, Port Elizabeth, 6045 Co.Regno(ciprone) [2] 0] of 9] Jol: fo]3[9]7]/[o]7 1.8 E-mail address wx@dirkmyburphco.za 19 FaxNo _086 559 3713 1.10 Phone No LT tAntnorsed persone 2,_EMPLOVEE DETAILS CHATARUKA is an offence to make a false statement, DATE ___04/05/2020.UNEMPLOYMENT IN: ANCE ACT 63 OF 2001 Employers Deelarat 1. of Employees for the ‘March 2020 to be supplied terms of Section 56(1&3) ley (053) 832 7218, 1, EMPLOYER DETAILS LL UIF Employer Reference No [2] 2] 4] s[ 9] 2] 3 ©1.3 Trading name of business LS Address where employees liste 18 E-mailladdress _tax@dirkmyburghco.za 1.9 Fax No 2,_EMPLOYEE DETAILS, BOOYSEN (043) 701 3263; Blftn (081) 447 9383: Branch No F different to the address in 1.4) (086 559 3713 (C1 (021) 441 8024;Web (013) 686 0235;PE (0M SRO 1.2 PAYE Reference No (if registered with sars) [7] 1] 8 [o[ 7] 8 [6 14 Physical Address 1.6 Postal address 1.7 Co. Reg.No (CIPRO No) 1.10 Phone No 2 3 idsworth Stret, Gl 2219;George (044) 873 2568: Pb 1d, Port Elizabeth, 6045 2}ofolo ‘folifolsfo[7[/fo[7 Authorised person** |, Detlef Romatzki, ID 6204135072082, declare that EMPLOYER SIGNATUREUNEMPLOYMENT INSURANCE ACT 63 OF 2001 un ployers Deelara mn of Em s for the month of March 2020 ROCKMAN address _tax@dirkmyburghcoza 1.9 Fax No 086 559 3713 14 1.6 Postal addres 17 Co, Reg.No 1.10 Phone No PAYE Reference No (If registered wi Physical Address _6 Pax Sweet, Sidwel wroNnoy [2] 0] ofo]/ is an offence to make a DATE 04/05/2020,UNEMPLOYMENT INSURANCE ACT 63 OF 2001 Employers Declaration of Employees for the month of Mareh 2020 ms of Section 56(1.&3) read with Regulation 13(1&2) wath (1)873 2219;George (8) #73 2568; Pmb (033) 394 S049; Kimberiey (053) 832 728, 1, EMPLOYER DETAILS 1 UIF Employer Reference No [2] 2] 4] 5] 9 2] 3] Trading name of business _Renelex 1A. Physical Address LS. Address where emplayees listed in Item 2 work iFdiferent tothe address in 14) 1.6 Postal address 22 Handsworth Street, Glen Hued, Por Elizabeth, 6045 17 Co.Regnoccirroney [2[olo]9[/ [ol ifo] [9] 7]/o[7 1.8 Enmailadiress ax@diamyburgh.coza 1.9 FaxNo 0865393713 1.10 Phone No 1.1 Laathoried person 2._EMPLOVEE DETAILS Branch No isan offence to make a false statement J, Detlef Romatzki, ID 6204135072082, declare t ee EMPLOYER SIGNATURE _ DATE __ 04/05/2020UNEMPLOYMENT INSURANCE ACT 63 OF 2001 mployers Declaration of Employees for the m th of March 2020) 1, EMPLOYER DETAILS 1.1 UIF Employer Reference No 1.3 Trading name of bu: 72] FEE Renelex LS Address where employees listed in lem 2 work (if differer 1.8 E-mailaddress _taxi@dirkmyburgh.co.za 2._ EMPLOYEE DETAILS, WILLIAMS. 19 Fax No’ Branch No PAYE Reference No (if registered with sans) [7] 1] 8 [0] 7] 8[6[3]2 Physical Address _6 Pax Stree, Sidwell, Port Elizabeth, 6001 Postal address 22 Handsworth Street, Glen Hurd, Port Bl Co.Reg.No(ciPRONe) [2] 0] [9] [oli fo]3}9 10 Pr lo the address 086 559 3713 [Authorised person*= I, Detlef Romatzki, 1D 6204135072082, declare that the af EMPLOYER SIGNATURE ue and correet. I understand that it is an offence to make a false statement. DATE ___ 04/05/2020,UNEMPLOYMENT INSURANCE ACT 63 OF 2001, ung) mployers Declaration of Employees for the month of March 2020 873 2219,George (O44) 873 2568; Lem (043) 7013263: bite (051) 4479353. C4 (O31) 441 S024. We 013) 656 0233:0E (041) S86 1S41:Cma (01 2 7218, 1, EMPLOYER DETAILS 1.1 UIF Employer Reference No [2] 2] [3 ©13 Trading name of business _Renelex 15. Address where employees listed in Item 2 work (if different 10 the address in 4) PAYE Reference No (If registered with SARS) [7 [1] 8 [0 [7] 8 [6 Street, Siduel 22 Handsworth Street, Glen Hurd, Port Elizabeth, 6045 17 Co. RegNo(CiPRONo) [2] [0] 9]/ Toft] 0] 3] 9] 7[/ [0] 7 18 E-mail address tax@diskmyburgheoza 1.9 Fax No (086 559 3713 1.10 Phone No [LT LAuthorised person” 2._EMPLOVEE DETAILS (as wig ded HSA 1D No) |, Detlef Romatzki, 1D 6204135072082, declare that the ey As true and correct. | understand that itis an offence to make a false statement. EMPLOYER SIGNATURE. DATE ___ 0405/2020, Is wee ot obs envamenwnflUNEMPLOYMENT INSURANCE ACT 63 OF 2001 Employers Declaration of Employees for the month of ‘March 2020) 1.1 UIP Employer Reference No 23] [Jem DL ©13 Trading name of business _Renelex LA. Physical Address LL Address where employees listed in tem 2 work (iF different to the address in 1.4) 1.6 Postal address 22 Handsworth Street, Glen Hurd, Port 17 Co,ReznocciproNnoy [2] 0] 0] 9]! [oli Jofs}o[z]/[o7 18 E-mailtaddress tax@dirkmyburgh.coza 1,9 Fax No 086 559 3713 1.10 Phone No 1.1 Authorised person** 2,_EMPLOYEE DETAILS. (43g ode HSA ID 8) Trion 1, Detlef Romatzki, 1D 6204135072082, declare that the abov' itis an offence to make a false statement. EMPLOYER SIGNATURE DATE __ 04/05/2020UNEMPLOYMENT 1 Employers Declaration of Employees for the m Information to be su URANCE ACT 63 OF 2001 uy Mareh 2020 130.82) 3: Kimberley (055) 832 7 EMPLOYER DETAILS L1_ ULF Employer Reference No [2] 2] 4] 5] 9] 2] 3 1.2 PAYE Reference No (i registered with Sars) [7] 1] 8]0]7[8]6]3]2 ©1.3 Trading name ofbusiness _Renelex 1.4 Physical Address _6 Pax Sweet. Sidwell, Port 1.5. Address where employees listed in Item 2 work (if diferent to the address in 1.4) 1.6. Postal address 22 Handsworth Street, Gl 17 Co.Regnocciprono) [2] ofofo]y [oi fo]3[o]7|/[o]7 address _tax@dirkmyburghco.za___ 1.9 Fax No (086 559 3713 1.10 Phone No EMPLOYEE DETAILS BADASAR, is an offence to make a false statement, DATE 04/05/2020, cae Tin CeUNEMPLOYMENT INSURANCE ACT 63 OF 2001, Employers Declaration of Employees for the month of ‘Mas 2020 1.1 UIF Employer Reference No 01.3 Tra yg name of business 1.5. Address where employees listed in Kt LS Eom EMPLOY DETAILS (053) 701 326%: lft (05 2] 4] 5] 92) Renelex n 2 work (if differes Physical Address 16. Postal address 1.7 Co. Reg.No (CIPRO No) address _tax@dirkmyburghcoza 19 Fax No (086 559 3713 1.10 Phone No © {us wig needed HSA HO No) is an offence to make a false statement. DATE ___ 04/05/2020UNEMPLOYMENT INSURANCE ACT 63 OF 2001 wry loyers Declaration of Employees for the month of March 2020) Information to be supplied ‘terms of Section $6(183) read with Regulation 13(1&2) (055) 394 5069: Kimberley (053) 832 7218, 1, EMPLOYER DETAILS | UIF Employer Reference No [2] 2] 4] ©1.3 Trading name of business _Renelex. 1.5 Adress where employees listed in tem 2 work lax(@dirkmyburgh.co7a 1.8. E-mail address 2._PMPLOVER DETAILS. MCCHARLIE, (03 Dig oacded SA 1D No) 1.4 Physical Address 1.6 Postal address 6 Pax Street 22 Handsworth Street, Glen Hurd, Port 71 fsfol7[sfo well, Port Elizabeth, 6001 1.7 Co, Reg.No (CIPRO No) [2] 0 9} Topi fopsyo 1.9 Fax No 086 539 3713 1.10 Phone No [LL Authorised person rect. | underst Wit is an offence to make a false statement. DATE ___04/05/2020, ote aPLOYMENT INSURANCE ACT 63 OF 2001 the month of ‘Mareh 2020 joyers Declaration of E LL UIF Employer Reference No [2] 2] 4] 5] PAYE Reference No (If registered with SARS) Physical Address _6 Pax Su q 1.6 Postal address 22 Handsworth 17 Co.Regnocciprono) [2] 0Jo[9]/ [of ifol3]9[7]/[o]7 ©1.3 Trading name of business _Renelex LS Address where employees listed in lem 2 work (iPdifferent to the address in 18 E-mailladdress _tax@dirkmyburgh.co.za 1.9 Fax No (086 559 3713 2,_EMPLOYEE DETAILS BECKETT is true and correct, I understand- UNEMPLOYMENT INSURANCE ACT 63 OF 2001 uy 18 of Employees for t March 2020 ‘and termination of service. The employe same a any Bra yet. The completed for can also be faxed to-any of 1670; Mmabatho (0! ‘adn 043) 701 3263: fn (051) 447 9333; CT (021) 441 8024;WUb (013) 656 0253;PE (O41) $86 154 (033) 394 5069; Kimberley (053) 832 7218, 1. EMPLOYER DETAILS. 1.1 ULF Employer Reference No [2] 2] 4] sf 9] ) 497 3293: DI 3662156; Polokwane (015) 290 (O11) 873 2219-George (044) $73 2568; Pa No L2_ PAYE Reference No (If registered with SARS) vss _Renelex 14. Physical Address [LS Address where employees listed in Item 2 work (i different to the address in 1.4) 16 Postal address ‘Street, Glen Hurd, Port 17 Co.Regnocipronoy [2] ofofo]fofifols[o][7|/[o]7 L8 E-mailladdress _taxi@diskmyburgh.coza 1.9 Fax No (086 559 3713 L10 Phone No TA Authorised person* 2._EMPLOVEE DETAILS arated SA HD No) JORDAAN J_|oislolelolo|sl2{slolo|s| 2] 8266 Joo} 129 J2ia)elijila ‘Yes |, Detlef Romatzki, ID 6204135072082, dectare that th abpve ip nce to make a false statement EMPLOYER SIGNATURE DATE __ 04/05/2020. ‘DESCRIELIONS.UNEMPLOYMENT INSURANCE ACT 63 OF 2001 Employers Deelarat F Employees for the month of. March 2020) {adn (05) 701 3265; Commissioner of any cl st forward this Frm ment Insurance Fund at (012) 33 1 of the following numbers: Pea (02) 309 5142/3286; Shb (011) 497 3293; Dba (031) 366 2156; Polokw ‘9385; C1 (021) 441 80D4: Wah (013) 656 0233:PE (O41) 586 1541 Gm (011) 873 2219;George (O44) 873 2568; P Bifta (081) 447 (033 1: Kimberley (053) 832 7218 1. EMPLOYER DETAILS 1.1 UIF Employer Reference No [2] 2 4] 5] 9] 2[ 3 Branch No 1.2. PAYE Reference No (If registred with SARS) [7] 1] 8]0[7]|8]6[3]2 ©1.3 Trading name ofbusiness _Renelex 14 Physical Address _6 Pax Sweet. Skdwell Port Elizabeth, 6001 LS Address where employees listed in lem 2 work (if different to the address in 14) 1.6 Postal address 22 Handsworth Street, Glen Hurd, Port Elizabeth, 6045, 17 Co.Regnoccprono) [2] 0] ol 9]/ [ol ifofs]sfz[/[o]7 1.8 F-mailladdress tax@dirkmyburghcoza 1.9 FaxNo _086 5593713, 1.10 Phone No [Authorised person=* 2._ EMPLOYEE DETAILS GROOTBOOM ‘pie is an offence to make a false statement. DATE ___ 04/05/2020,UNEMPLOYMENT INSURANCE ACT 63 OF 2001, n of Employees for the month of ‘March 2020) s 130182) Employers Declarat ‘An employer mus by including new appoi the UIF whieh is closest tothe employer. The cr 1670; Mmabatho (018) 384 2688; East Lm (43) 701 326: (033) 394 5069; Kin (053) 832 7218, 1. EMPLOYER DETAILS. alokwane (015) 290 1.1 UIF Employer Reference No [2] 2] 4[ 5] 9] 2 1.2. PAYE Reference No (If egistered with sans) [7] 1] 8]o]7]8]o[3]2 ©13 Trad business _Renelex 14 Physical Address _6 Pav Sweet, Sidwell, Port Elizabeth, 6001 [LS Address where employees listed in tem 2 work (if different to the address in 14) 16 Postal address 22 Handsworth Street, Glen Hurd, Port Elizabeth, 6045, 17 Co.RegnocciProno) [2]o[o[9]/ Joli fol3fe[7|/Jo]7 18 E-mailladdress _tax@dirkmyburghcoza 1.9 Fax No (086 559 3713 1.10 Phone No Authorised person** EMPLOYEE DETAILS NAICKER, _ Detlef Romatzki, ID 6204135072082, declare that the abf ‘true and correct, I understand that it is an offence to make a false statement. EMPLOYER SIGNATURE. DATE ___ 04/05/2020. r jones estatsthconpe ners)UNEMPLOYMENT INSURANCE ACT 63 OF 2001 uri ‘March 2020) EMPLOYER DETAILS Lt uIF O13 Tradl ROMATZKI nloerretnnceno [2[2]-[5]5]2[3] [5] omnes no Rene 14 Pai 2 work (iFdiff 12. PAYE Reference No (If registered with SARS) I Address the address in 1.4) 16 Postal address 17 Co. RegNo \co7a_ (1.9 FaxNo 086 5593713 1.10 Phone No PI 6 Pax Srwt, Sidwell, Port El 22 Handsworth Street, Glen none) [2]ofofo]/ Jolt 1, Det true and correct, [ under stand th sce to make a filse statement, DATE ___ 04/05/2020UNEMPLOYMENT INSURANCE ACT 63 OF 2001 Employers Declaration of Employees for the month of | [ema un Branch No © 1.3 Trading nan of business _Renelex 1.2. PAYE Reference No (If registered with SARS) [7 [slo]? 6 Pax Sree, Sidwell, Port Elizabeth, 6001 9] Joltfolslof7 1.4. Physical Address LS Address where employees listed in lem 2 work (if different to the address in 1.4) 16 Postal address 22 Handsworth Street, Gk 17 Co. Reg.No(CIPRONe) [2] 0] 0 1.8 Esmailaddress tax@dirkmyburghcoza 1.9 Fax No (086 559 3713 1.10 Phone No 2._ EMPLOYEE DETAILS ua Dige barcode HSA ID Ne) 120 Jolrlolali YES |, Detlef Romatzki, ID 6204135072082, declar€ that the ghovg deformation is true and correct. I understand that itis an offence to make a false statement. EMPLOYER SIGNATURE, DATE ___04/05/2020 - ies body corp nate “aso or ownUNEMPLOYMENT INSURANCE ACT 63 OF 2001 of Employees for the month of Mareh 2020 Employers Deelarat Informati ) 309 $142/5286; 3) 656 0233:PE (Ot1) 586 1541;Gmn (053) 832 7218, 1, EMPLOYER DETAILS 1.1 UIF Employer Reference No [2] 2] 4] sf 9] 1,3 Tra 1) 875 2219sGeorge (044) 873 2568; Pmb 1.2. PAYE Reference No (If rey 7[ifsfo[7[s]o[s]2 name of business _Renelex - LA Physical Address _6 Pax Sweet, Sidwell, Por Elizabeth, 6001 1.5 Address where employees liste 12 work (if different to the address in 1.4) 6 Postal address 22 Handsworth Street, Glen Hurd, Port Elizabeth, 6045 17 Co.Regnocciprono) [2] ofo[o]/fofifo[s[o]7]/fo]7 1.8 E-mail address tax@dirkmyburgh.coza 1.9 FaxNo _086 559.3713 1.10 Phone No 11 LAuthorised person** 2,_EMPLOYEE DETAILS. * aa © ‘aa pig parsed HSA ID 0) ROMATZKI Hole 1, Del somatzki, ID 6204135072082, declan he above ingeijnatiogy is tryy“and correct. | understand that it is an offence to make a false statement. EMPLOYER SIGNATURE DATE ___ 04/05/2020