Application for Membership (Individual)

PINELANDS COMMUNITY IMPROVEMENT DISTRICT NPC

Registration No.: 2023/828331/08
APPLICATION FOR ADMISSION OF MEMBERSHIP BY A PRIVATE INDIVIDUAL

To the Board of the Pinelands Community Improvement District NPC, I hereby apply for admission of membership of the NPC to be entered into the NPC’s Membership Register.
Name*

First NameLast Name
General Note on Information

Under the Companies Act, the Members’ Register must contain the following information in respect of each member:(a) name; (b) business, residential or postal address; (c) email address (unless person has declined to provide anemail address); and (d) an identifying number unique to that person (e.g. a RSA ID number). However, the Pinelands Community Improvement District NPC will keep your unique identity number and email address provided confidential when any member or outside third party requests access to the Members’ Register under the Companies Act, unless you give your written consent.
Details of Owner representing the property
Name*

Name(s)Surname
ID number*
Residential Address*
Postal Address
Note: Where your residential address differs from your postal address, only your postal address will be recorded in the Members' Register.
Contact Details
Home tel.
Work tel.
Cellular*
Fax
Email address*
example@example.com
Notices and communication needs to be addressed to the (tick appropriate box):*

The physical addressThe postal addressThe email address
Opt-in to Pinelands Ratepayers & Residents Association communications

I wish to receive updates from the Pinelands Ratepayers & Residents Association
Are there multiple owners?*

YesNo
Details of Co-owner(s)
Name (Owner 2)*

Name(s)Surname
ID number*
Email address*
example@example.com
Signature*

Clear
Date*

MonthDayYear
Date
Name (Owner 3)

NameSurname
ID number
Email address
example@example.com
Signature

Clear
Date

MonthDayYear
Date
Details of Property

I am the registered owner/ co-owner (circle whichever is applicable), of the following property located within the Pinelands Community Improvement District.

Details*

	ERF	Physical Address	Unit Number (Apartment)
1
2
3
4
5

Name*

First NameLast Name
Date*

MonthDayYear
Date
Signature*

Clear
Signed at*
File Upload

Cancelof
Those unable to attend the meeting in person are strongly recommended to complete a proxy form. Non-attendance at the AGM for two consecutive years without completing a proxy will result in your membership of the CID being terminated per S13 of the CID’s memorandum of incorporation. Note that even if you complete a proxy, you can still subsequently opt to attend the AGM and vote in person.

Download Proxy Form
Should be Empty:

PINELANDS COMMUNITY IMPROVEMENT DISTRICT NPC

APPLICATION FOR ADMISSION OF MEMBERSHIP BY A PRIVATE INDIVIDUAL

General Note on Information

Details of Owner representing the property

Contact Details

Details of Co-owner(s)

Details of Property