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General Information
Request ID
Request Status
New
Application Submitted
Completed
Name
*
Outlet Information
Outlet Name
*
*
Street and House Number
*
*
Suburb
*
Store Opening Time
*
*
Street Extension or Shopping Complex
*
City
*
Store Closing Time
*
*
Postal Code
*
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Province
*
Store Opening Days Portal
*
Postal Code
*
Country
*
Data Sharing Consent
Unassigned
Yes
Main Contact Information
Contact Name
*
*
Contact Surname
*
*
Contact Email
*
*
*
Contact Phone
*
*
Contact Mobile
*
*
Owner Information
Owner First Name
*
Owner Surname
*
Owner ID Number
*
Owner ID Type
RSA ID
Passport
Asylum Seeking Document
Other
Owner Other ID Type
*
