t o o t * 2 . ,

MEMO

PLAINTIFF'S FULL NAMES : ^ y î L lW A

CASE NO. :

ADDRESS :

SA CITIZEN OR NOT :

Nature of injuries :

pate end time of Incident :

Quantum :

pve-witnesses :

Other witnesses :

Number of visits to doctor or hospital :

Specify visits to doctor or hospital :(names and venues)

Employed or n o t: .

feature of employment : .

income and propf thereof :

Current state of injuries :

If future loss of earnings are claimed, the relevant duration and proof that it was so claimed :

Names of assaulters :

Were criminal charges laid, if so where?

Was an ID parade attended?

Issued Dy

lx 4 M iO ~Case no.

2 2 . C 9 . 9 2 0 7 2 6

C lerk o f the c d M I F T H E C Q U O T KLERK VAN Die HOF

Date - Revenue Stamp

No. RM2 Summons Commencing Action (Ordinaiy)Sued out byN ic h o l ls Cambanis, Koopasarany & P i l l a y c/o Adams & Ar’ams ShorBurg*129 Church S t r e e t PRETORIA 0002

Postal addressP .O . Box 101M - PRETORIA - 0001

Signature of Pontiff or his Attorney

- 09 - 2 3

■ k.iricIn the Magistrate’s Court for the District of P r e t O ria '

Between MOSHANYANA MATTHEWS MAHLOMA

held at P re to r ia

Plaintiff

and MINISTER OF DEFENCE D efendant

To: THE MINISTER OF DEFENCE, WHO IS CITED h ere in in h is c a p a c ity as head o f th e SOUTH AFRICAN DEFENCE FORCE, and as such re sp o n s ib le f o r and in c o n t r o l o f members o f th e SOUTH AFRICAN DEFENCE FORCE, c/o The S ta te A t to rn e y , 888 R oya l S t . M ary 's B u ild in g , 85 E l o f f S t r e e t , Johannesburg.

You are hereby summoned that you do within 21 (tw en ty one) days of the service of this summonsdeliver or cause to be delivered to the CLERK OF THE AFORESAID COURT and also the PLAINTIFF OR HIS ATTORNEY, at the address specified herein,a notice in writing of your intention to defend this action and answer the claim ofMOSHANYANA MATTHEWS MAHLOMA an a d u lt m ale, unemployed o f A 619 Pho la P a rk , TOKOZA.

the plaintiff herein, particulars whereof are endorsed hereunder

(1 ) Particulars

Plaintiff s claim against defendant is for payment of the sum/balance of R for:

SEE ANNEXURE

Wherefore plaintiff prays for judgment against the defendant in the said sum, with costs.

Costs if the action is undefended will be as follows: Summons JudgmentR c R c

Attorney’s charges............................................................................. 150 00 125 00Court fe e s ......................................................................................... 10 00Messenger's fe e s ...............................................................................Messenger's fees on re-issue...............................................................

Totals .............................................................................................. R R

Total .......................................................................................................................................... R

(See back)

(N, Copyric*" Hortors Stationery

- £ -

^ ' T h e P l a i n t i f f h a s g i v e n n o t i c e in t e r m s of S e c t i o n 113 of

t h e D e f e n c e Act.

7. N o t w i t h s t a n d i n g d e m a n d ) t h e D e f e n d a n t h a s f a i l e d a n d / o r

n e g l e c t e d to p a y t h e a f o r e s a i d s u m a s c l a i m e d .

W H E R E F O R E t h e P l a i n t i f f c l a i m s : -

a. P a y m e n t of t h e s u m o f R I O 0 0 0 . 0 0 ;

b. I n t e r e s t o n t h e a f o r e s a i d s u m at t h e r a t e of 18.5*/. per

a n n u m f r o m d a t e of j u d g e m e n t to d a t e of p a y m e n t ;

c. C o s t s o f s u i t ;

d. F u r t h e r a n d / o r a l t e r n a t i v e r e l i e f .

D A T E D at J O H A N N E S B U R G o n t h i s t h e 0 - ^ d a y o f 1992,

N I C H O L L S , C A M B A N I S , K O O P A S A M M Y A N D P I L L A Y P L A I N T I F F ’S A T T O R N E Y S E 3 R D F L O O R , K I N E C E N T R E 141 C O M M I S S I O N E R S T R E E T J O H A N N E S B U R G R E F : V S / P P / 9

c/o Adams & Adams Shorburg429 Church S tr e e t P . 0 . Box 1014 PRETORIA T e l 320-8500R e f: M. BEDHESI/mvd P 169/92

P A R T I C U L A R S OF C L A I M

T h e P l a i n t i f f is M O S H A N Y A N A M A T T H E W S M A H L O M A a n a d u l t m a l e ,

u n e m p l o y e d o f A 6 1 9 P h o l a P a r k , T O K O Z A .

T h e D e f e n d a n t is t h e M I N I S T E R O F D E F E N C E , c i t e d h e r e i n in

h i s c a p a c i t y a s h e a d of t h e S O U T H A F R I C A N D E F E N C E F O R C E , and

s u c h r e s p o n s i b l e for a n d in c o n t r o l of m e m b e r s o f t h e

S O U T H A F R I C A N D E F E N C E F O R C E , c / o T h e S t a t e A t t o r n e y , 8 8 8

R o y a l S t . M a r y ’s B u i l d i n g , 8 5 E l o f f S t r e e t , J o h a n n e s b u r q .

O n or a b o u t t h e 8 t h A p r i l 1 9 9 E a n d at P h o l a P a r k , T o k o 2 a,

t h e P l a i n t i f f w a s u n l a w f u l l y a n d w i t h o u t l a w f u l

j u s t i f i c a t i o n a s s a u l t e d b y m e m b e r s o f t h e S O U T H A F R I C A N

D E F E N C E F o r c e , w h o at m a t e r i a l t i m e s h e r e t o w e r e a c t i n g

w i t h i n t h e c o u r s e a n d s c o p e of t h e i r e m p l o y m e n t as m e m b e r s

o f t h e S O U T H A F R I C A N D E F E N C E F O R C E .

A s a c o n s e q u e n c e o f t h e a f o r e s a i d a s s a u l t , t h e P l a i n t i f f

s u f f e r e d b o d i l y i n j u r i e s .

In c o n s e q u e n c e t h e r e o f , t h e P l a i n t i f f h a s s u f f e r e d d a m a g e s

in t h e a m o u n t o f T E N T H O U S A N D R A N D ( R I O 0 0 0 . 0 0 ) in r e s p e c t

o f c o n t u m e l i a , p a i n a n d s u f f e r i n g , l o s s o f a m e n i t i e s o f l i f e

IN T H E M A G I S T R A T E’S C O U R T F D R T H E D I S T R I C T O F P R E T O R I AH E L D AT P R E T O R I A C A S E N O t 72fefe5/92

In the m a t t e r b e t w e e n t -

M O S H A N Y A N A M A T T H E W S M A H L O M A P l a i n t i f f

and

T H E M I N I S T E R O F D E F E N C E D e f e n d a n t

A F F I D A V I T IN T E R M S O F R U L E 10

It the u n d e r s i g n e d ,

C A R O L I N E H E A T O N - N I C H O L L S

do h e r e b y m a k e o a t h and s a y th a t t -

1. I a m an a t t o r n e y of t h e S u p r e m e C o u r t o f S o u t h A f r i c a

( T r a n s v a a l P r o v i n c i a l D i v i s i o n ) , d u l y a d m i t t e d a n d

p r a c t i s i n g a s s u c h in p a r t n e r s h i p u n d e r t h e n a m e a n d s t y l e

of N I C H O L L S , C A M B A N I S A N D S U D A N O , at 2 3 r d F l o o r , K i n e

C e n t r e , 1^1 C o m m i s s i o n e r S t r e e t , J o h a n n e s b u r g .

2. T h e f a c t s h e r e i n c o n t a i n e d a r e w i t h i n m y p e r s o n a l k n o w l e d g e

and b e l i e f a n d a r e b o t h t r u e a n d c o r r e c t .

3. 1 a m a c t i n g f o r t h e P l a i n t i f f in t h i s m a t t e r . S u m m o n s

h e r e i n w e r e i s s u e d at t h e A b o v e H o n o u r a b l e C o u r t o n t h e 2 2 n d

S e p t e m b e r 1 9 9 2 . At t h e r e q u e s t of t h e D e f e n d a n t , P l a i n t i f f

g r a n t e d a n e x t e n s i o n f o r t h e e n t e r i n g o f a n A p p e a r a n c e to

D e f e n d b y D e f e n d a n t .

f o

- 2 -

Case

25.

26.

27.

26.

T?.

30.

31.

32.

33.

34.

No:

72644/92

72664/92

72656/92

72657/92

72636/92

72635/92

72642/92

72641/92

72646/92

72647/92

Plaintiff

Nophumzile Bckode

Mbekeni Makiki

Jojo Kuzanl

Amos Fumbatha

Albert Goutyana

Boy T6hetsha

Peterson Sweli

Walter Knisi

Priscilla Qaqane

Nophakamile Khala

ii

i

r - 2 2 2 -0 9 DO'1/2

'92 15:32 STATE ATTORNEY PTA 012 32200177 P. 4/4

Case No:

25. 72644/92

26. 72664/92

27. 72656/92

26. 72657/92I

2?. 72636/92ii

53. 72635/92

31. 72642/92

32. 72641/92

33. 72648/92

34. 72647/92

Plaintiff

Nophumzile Bckode

Mbekeni Makiki

Jojo Kuzani

Amos Fumbatha

Albert Goutyana

Boy Tshetsha

Peterson Swell

Walter Hnisi

Priscilla Qaqane

Nophakamile Khala

CIVIL CLAIMS

Claimant: Tt h & ^ c, PWA-tttowp- ( Mft+H-©TSc>Pv

(i) Full Name and Address of Claimant:

t v . Q O f t 5 m M bA h f v M f t n ~ H e t v - c u u f t H - t o w t A

A b l ® ! f r U o l # P cjl6? .U l o U - P " * - * * ( < 4 - 1 I

(ii) Occupation: .

(iii) Date of Birth:

______________________________________ H - 0 - 7 - f ^ S 1

(iv ) Identity No:

____________ s i o i ^ g a s ~ o q ? t f

( v ) Telephone Nos:

Particulars of Circumstances in which bodily injuries were

sustained. _ .

X T im < r crp / N J u J ^ e S , i j t + l q i o j - t ffpM

2.1. Cause of injuries:

ft-^ ^

a w r t " K o i U o L C w K c9 l %̂ c

Medical Treatment.

3.1. Provincial / Private Hospital where claimant was treated:

3.2. Was claimant treated by a private doctor? If so, names

and telephone numbers are required.

3.3 Hospital No: k j ^ 7 - ____________________________

3.4 Date of Admission and Date of Discharge:

____________________ ^ I q - 1 •

Employment

5.1. Occupation:

5.2. Name and Address of Employer at date of Accident:

5.3. Period of his employment, f r o m _______

to __________________________ .

5.4. Date of Resumption of Work:

H

5.5. Claimant's Income for the 12 months immediately preceding

the incident:

N

Dependant's Claim (Where the deceased was the breadwinner and is

survived by dependants). The following personal particulars of

the deceased's surviving spouse and children are required:

6.1. Full Names

B t r w rv\i

s and Addresses: 4r ■

u c h S u p r-C C V i \nm £) d r pn j ; u j~ p o u r o n b ( c j O c & f i

■ M A

6.2. Relationship to deceased:

H T

6.3. Date of Birth:

M i *

6.4. Occupation: I^Vcr^c O a J cr D -e c x T 1̂

£

6.5. Name and Address of Employer at /date of Death:

__ __________________ _______h / A •

¥

6.6. His or her income for the 12 months immediately preceding

the accident: 1 i

U \ '

7. Injuries:

7.1. Brief discription of injuries: D o d 5 0 ejjecX ^nc>r

J o b s \pSS (0 . Q m g n - f U o f b-J l -eft

S t ^ i e u u v p f g l g u u l p p U C u K

u §

7 ' 2- Pqih Is 1>>erg s H ll p g jr y F z>r h e w I

^ , I ' D C r ) T ) 7 V P P a Z j p r £ > ( ^

D i d f t o ^ t . & . p O c T 7 X £ = L ^ %

J < r u p ^ n r \ ^ - S < j Y > n < r a v ~ v ? o i J " ' M

€ _ J ^ > l o v H ^ i r e . c v r v ^ o j n ^ / . G . J ^ e > M < 9 I c H O U J

^ O c r v J J i a A p t r i n ^ S ^ r ^ i e c r r x e c v J ^ i J v u r \ c J \ ~

• BUITEPASI&NTE EN/OF ONGEVALLE AFD. • OUTPATIENT AND/OR CASUALTY DEPT.3 3 6 6 3

............. HOSPITAAL • HOSPITAL PASIENT • PATIENT No............

G P.-S 042-0192 T.P.H. 25B

Huwelikstaat Marita! state

............... l . J ...... ...............................

\ ' k 9 .... fc.l.fa......i k x j k .

, u S > ' .....................3 ....

.......... '!/ ■ ..........% i d > ........

Beroep I I Geboortedatum Occupation...................................... ............................................ Date of birth.........

Volgno. Serial N o ..

OpgeneemAdmitted

Indeling Classification..... .

N aam van persoon verantwoordelik vir betaling van rekening Nam e of person responsible for paym ent of account.......................

C<

Sy/Haar adres • His/Her ad dress.................................................................................................................................................................

N aam van werkgewer • Nam e of em ployer..............................................................................................................................................

— Adres van werkgewer • Address of em ployer.........................................................................................................................................

" N aam van siekefonds S /F , Nam e of sick fund............................................................................................................................................................................. S /F N o . .

•Jaarlikse gesinsinkomste • Annual family income Uit alle bronne From all sources

Broodwinner • Breadwinner................................................................................................................................... R

Vrou • W ife .................................................................................................................................................................. R

Ander afhanklikes • Other dependants............................................................................................................... R

Totaal • Total

*Getal persone in gesin (broodwinner ingesluit)Number of persons in household (including b readw inner).

Meld ouderdomme van afhanklikesState ages of dependants..............................................................

Rede vir afhanklikheidReason for dependence...............................................................

* (Minderjariges van 16 jaar en ouer wat selfonderhoudend is, m oet uitgesluit word) (Minor children of 16 years and older who are self-supporting must be excluded)

! Datum van ongeluk/besering Plek i Date of accident/injury.......................................................................................... Place..

Persoon wat beseerde ingebring hetPerson who brought in the injured.....................................................................................

Sy/Haar adres His/Her ad dress.

Sy/Haar handtekening His/Her signature.....

W as beseerde: W as injured:

Geteken: Opnemingsbeampte Signed: Admj

Die aard van die)The nature of the \

Getuie

(i) Onder die invloed van djankyj Under the influeng

(ii) By sy/haar bewyssyn? C onscious?.....

vfr reKenincjdaeleTndes vrygestel word, ^be disclosed for accounting purposes.

Tyd T im e .

en voertuig No. and vehicle No.

GetekenW itn ess ............... rr

DatumD a te ........................ \ M 3 ' . 1 . 2 . .........

KlagteCom plaint.............. . v ........................................................._ r ____________ _ . - ------------------------— ---------------------------------------------------------------- — ----------Huidige siekte Present illness

ONDERSOEK/BEHANDELING/VORDERINGEXAMINATION/TREATMENT/PROGRESS

T.P.H. 256

CO

SLEGS VIR AFSKEURSTROKIES FOR COUNTERFOILS O N L Y

T.P.H. 25B

• \

D atum , ^ Date

s Betalings • PaymentsDatumDate

Betalings • Payments Betalings • Payments

-

* (Rekenings • Accou its

-------------------------

•(

________________________________________

i

T P K 6Z£

DEPARTEMENT RADIOLOGIE/DEPARTMENT OF RADIOLOGY MAG SLEGS DEUR GENEESHEER VOLTOOI WORD/MAY ONLY BE COMPLETED BY A DOCTOR

H O SPITA AL/HO SPITAL R6 No.

PASlENT/PATIENT ............. LOPEND i------------------------------------------1---------- BED VER V O E R i-------- 1 DRAAGBAAR i------- 1. / W ALKING I____ I______ BED T R A N S P O R T I_____I STRETCHER I------- 1

HOSP. No. ..................................— — .......................................................... CT^ C, ------- -----------DOEN IN S A AL i-------- 1I____ I______ DO IN W A R D l____J

STOELCHAIR

O U D E R D O M / INDELING / AFDELING/ VOORHEEN G ERA DIO G RA FEER / JA / N E E /

AGE CLASSIFICATION W ARD PREVIOUSLY R A D IO G R A P H E D YES NOG&AJG7s e x '

VORIGE RC O NDERSOEKE M ET D A TU M S/PREVIO U S R8 EXAM S W IT H DATES

VOLLEDIGE KUNiESE BEVINDINGS EN INDIKASIE V IR A AN VR A A G /C O M PLETE CUN ICA L FINDING S W ITH INDICATIONS FOR REQ UEST

O NDERSO EK A A N G EV R A /E XA M IN A TIO N R EQ U ESTED ,^ io/

> V _ -v 1 / * r v I » i* £Y - y i s

IS PASl£NT M O O NTLIK SW ANGER? IS PATIENT POSSIBLY PREGNANT?

JAYES

NEENO

DEPARTEMENTSHOOF HEAD OF DEPARTM ENT

VER SLA G /REPO R T JAYES

NEENO

PRIVATE PA Sl£NT : RADIOLOOG PRIVATE PATIENT : RADIOLOGIST

VERW YSENDE GENEESHEER (Drukskrif) REFERRING DO CTO R (P lease Print)

HANDTEKENING EN DATUM SIGNATURE AND DATE

I * 1

VIR DEPARTEM ENT RA D IO LO G IE/FO R DEPARTM ENT OF R A D IO LO G Y

AANKOM S (A) VER TREK (D) VAN PASlENT

ARRIVAL (A) DEPARTURE (D) OF PATIENT

R A D IO G R A A F/R A D IO G R A P H ER

DATUM VAN O N D ERSO EK

DATE OF E XA M IN A TIO N

STUDENT: VOLLE N A A M /FU LL NAME

D E U R LIG TIN G STYD /S C R E EN TIME AANTAL B ELIG TIN G S/NO OF EXPO SU R ES

FILMS: G R O O TTE EN G ETAL/PLATES: S IZE AND NUMBER

KONTRAS TO E G E D IE N /C O N TR A S T HOEVEELHEID EN S T E R K T E /A M O U N T AND STRENGTH

PARAGON (E16262) G

ent • Patifent . '>• Nommer • Number

Datura- D ate. v i**

Voorskrif besonderhede Details of prescription

Hoev. uit. Qty. issd.

Apteker . Pharmacist

o /y A i w a r , - Q w ----------f JScf /V/

V ' or equivalentof ek vyra ie r^

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of ekwivalent

or equivalent

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or equivalent

ofekv.: ji , , IOr 6CjUIVcl6r''. jf 1

of ekwivalent j

or equivalent j

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or equivalent

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**-*-r ' ® ^ - .x - - * ^ - e ~ ^ f e c J ! _ —" £ j't-â ^ CTC ’X l

Collection Number: AK2702 Goldstone Commission of Enquiry into PHOLA PARK Records 1992-1993 PUBLISHER: Publisher:-Historical Papers, University of the Witwatersrand Location:-Johannesburg ©2012

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