Assessment questionnaire


By completing the assessment form below we will be able to assess whether you qualify for either temporary or permanent residence in South Africa. Please complete the assessment form and answer all questions and submit to our offices.

 

  

Personal Particulars

Surname 
First Names 
Title 

Gender 
Street Address  

City  
State 
 Postal Code 
Country 
   Telephone:
Telephone: Country Code 
Area Code 
Home Telephone Number 
Business Telephone Number 
Mobile Telephone Number  
E-mail Address 
Birth Date, Month and Year       
City of Birth 
Country of Birth 
Marital Status 
Number of Children         Ages 
Citizenship  
  

Spouse or Partners particulars

Are you married or in a permanent cohabitative relationship (spousal relationship) with your partner ?
   Yes No
Is your spouse a South African citizen or permanent residence permit holder?
   Yes No
How  long have you been married or in a spousal relationship?
   Less then 5 years More then 5 years
Spouse/Partner Full Name 
Title . 
Gender 
Birth Date, Month and Year      
  

Qualifications, work experience & skills

What is your Highest Level of Education 

Details of your work or professional experience

 

 
  

Entrepreneurial skills & business experience

Detail your business skills in your own business (either as owner or equity holder) or key management skills within a company over the last 5 years 
  

Language proficiency

 Speak English 
Read English 
Write English 
  

South African Ancestral link?

If you are connected by way of blood or marriage through ascendance or descendance (within two degrees of kinship) to a South African citizen you may have the right to South African citizenship by descent, ie. either a Parent or Grandparent who is or was a South African Citizen or Permanent Resident, please submit a response in the block provided.

Relationship

 
  

This section must be completed by persons who want to be assessed in the "Retired persons" and "financial net worth" categories

N.B. The calculations in this category will be assessed at the ZAR value at time of the assessment

Furnish the value of transferable pension or life time annuity (in the currency it is paid to you ). Any pension or annuity due to your spouse or partner must be included. Currency
 Value
Furnish the total amount of your financial net worth (in the currency it is invested).   and specify the income payable to you and your spouse and partner per month from such investment   Currency
 Value
Furnish the total value of immovable property owned by you and any rental value and any rental value which would accrue to you from such property. (in the currency it is invested).   and specify the income payable to you and your spouse and partner per month from such investment   Currency
 Value

Total

  Currency
   Value
  

Other Questions

Have you or your spouse or partner  ever:
been convicted of or are currently charged with any crime or offence in any country ? 
applied previously for any visitors permit / visa /  Study Permit /Work  Permit or Permanent residence permit for South Africa ? 
been refused a South African entry Permit or any had any visa refusal in any other country ? 
been refused admission to, or ordered to leave South Africa or any other country ? 
applied previously for citizenship by naturalisation or descent in South Africa ? 
Do you have a job offer from a prospective South African employer ? 

If you have answered "yes" to any of the questions above, please provide details below:

  
Under which category do
you wish to be assessed ?		 
How did you learn about our website ? 
  

Other Services

Do you require assistance with the movement of your household goods and motor vehicles to South Africa?
  Yes No
Do you require medical or general insurance?
  Yes No
Do you require assistance with the transfer and conversion of your local currency to South African currency?
  Yes No

We can only do this assessment if you complete this questionnaire fully
AND furnish the warranty requested

I guarantee  that the information furnished by me on this form is true and correct, to the best of my knowledge, and is being provided only for the purpose of providing sufficient information to enable a free assessment of the viability of my possible Immigration to South Africa
   Yes    No   
  

 

 

 

The information contained on this Website is of a general nature
and should not be regarded as legal advice. Specific action should
 not be taken on the basis of any of the material contained
on this Website without reference to this office
  Copyright in the content of this web site vests in Julian Pokroy.
 

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