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102 No. 33075 GOVERNMENT GAZETTE, 1 APRIL 2010
FORM 14
REGISTER OF PERSONS CONVICTED OF ABUSE OF OLDER PERSONS
DEPARTMENT OF SOCIAL DEVELOPMENT
OLDER PERSONS ACT, 2006 (ACT NO. 13 of 2006)
PART A: DETAILS OF PERPETRATOR
Case
no.
Name of
convicted
Gender Physical
address
Identity
number
Offence Penalty Area
where
Date
person offence
!
• M IF I
AGE
I !
I ~vas
committed
PART B: DETAILS OF VICTIM
Cas Name identity Gender Physic ! Place Type Who reported
e no of Number al /addres of
victim addres s where abus
s abuse e
occurre
d
M F • Nam Relationship
AGE e to victim
•
PART C: RELATIONSHIP BETWEEN PERPETRATOR AND VICTIM:
Date I
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