Integrated Port Management System

Port Entry Pass Application

You have some form errors. Please check below.

Your form validation is successful!

Port: *

New Application Resubmit Reverted Application Appeal On Rejected Application

Particulars of Applicant

Port: *

Company Name:*

Department:*

Full Name of the Applicant:*

Surname of the Applicant:*

Pension/Employee No.:*

ID/Passport No.:*

Occupation:*

Email:*

Mobile No.:*

Home Address:*

Company Address:*

Company Telephone No.:*

Company Fax No.:*

Permit Requirements: (This Section is to be completed by the Sponsor Company / Authorized Signatory )

Permanent Permits

TPT Operated Terminals

(Applicant to specify the specific TPT site, for which purpose access is required. The TPT Terminal Manager / Designated authority is required to approve the application, where access to a specific TPT site is required)

NPA Sites

(Applicant to specify his/her specific place of work. Business Unit Manager/Line Manger to approve application where access to other NPA sites/Leaseholder Sites is required to perform job function)

Specific NPA Sites

Specify Name & Specific Location of Area/Site:

Private Terminals / Lease Holding Sites

Specify Name And Specific Location of Lease Holding Site:*

Physical Address:*

Permits

Temporary Permits Permanent Permits

Temporary Permits:

(This category applies to all individuals who are not permanently employed or based on NPA owned or managed by the Port)

Permanent Permits:

Yes No

(Permanent Permits will only be issued to persons who are permanently employed, with the Security controlled / restricted area within the boundaries of the NPA owned/managed by the Port, on a permanent basis)

Reason for Application:*

Particulars of Applicant

Port:*

Company Name:*

Department:*

Full Name of the Applicant:*

Surname of the Applicant:*

Pension/Employee No.:*

ID/Passport No.:*

Occupation:*

Email:*

Mobile No.:*

Home Address:*

Company Address:*

Company Telephone No.:*

Company Fax No.:*

Permit Requirements: (This Section is to be completed by the Sponsor Company / Authorized Signatory )

Permanent Permits

TPT Operated Terminals

NPA Sites

(Applicant to specify his/her specific place of work. Business Unit Manager/Line Manger to approve application where access to other NPA sites/Leaseholder Sites is required to perform job function)

Specific NPA Sites

Specify Name & Specific Location of Area/Site:

Private Terminals / Lease Holding Sites

Specify Name And Specific Location of Lease Holding Site:*

Physical Address:*

Contractor Information

Company Name:*

Contract No.:*

Name of Contract Manager/Supervisor:*

Duration of Contract In Months:*

Name of Company for whom services are to be rendered:*

Name of Contract Manager responsible to monitor contract.:*

Contact Telephone No.:*

Mobile No.:*

Permits

Ad Hoc Permits Temporary Permits Contractors Permanent Permits

Ad Hoc Permits:

(Only for holders of permanent permits who have left their permits at home and are in possession of a valid ID document)

Temporary Permits:

(This category applies to all individuals who are not permanently employed or based on NPA owned or managed by the Port)

Contractors:

Indicate the Area of Construction

Permanent Permits:

Yes No

Reason for Application:*

Particulars of Applicant

Port:*

Company Name:*

Department:*

Full Name of the Applicant:*

Surname of the Applicant:*

Pension/Employee No.:*

Occupation :*

ID/Passport No.:*

Company Telephone No.:*

Company Fax No.:*

Email:*

Mobile No.:*

Company Address:*

Home Address:*

Vehicle Particulars

Vehicle Make:

Vehicle Registration No.:

Permit Requirements

Reason for Application

Reason for Application: *

Vehicle Particulars

Make:*

Model:*

Registration No.:*

Description of Truck:*

Is the Vehicle Registered in Company Name:*

Yes No

Is the Vehicle Painted In Company Colors or Have Clear Marking of Company on the Vehicle:*

Yes No

Detailed Reason to Substantiate for Issue of Vehicle Permit

Detailed Reason to Substantiate for Issue of Vehicle Permit:*

Company Related Information

Name of Company:*

Telephone No.:*

Company Fax No.:*

Company Address:*

Particulars of Company Representatives

Port:*

Name of the Applicant:*

Surname of the Applicant:*

Occupation:*

Residential Address:*

Department:*

Work Telephone No.:*

Pension/Employee No.:*

ID/Passport No.:*

Home Telephone No.:

Mobile No.:*

Email:*

Permit Requirements

If a Contractor State Contract No.:

Duration of Contract In Months:

Temporary Permits :

Particulars of Applicant Requesting The Issue of A Visitors Permit

Port:*

Company Name:*

Department:*

Full Name:*

Occupation:*

Surname of the Applicant:*

Pension/Employee No.:*

ID/Passport No.:*

Email:*

Mobile No.:*

Company Address:*

Home Address:*

Company Fax No.:*

Company Telephone No.:*

Detailed Reason To Substantiate Application For Issue of Visitors Permit:*

Particulars of Company Requesting The Issue of A Visitors Permit

Company:*

Division/Section:*

Name of Authorized Person:*

Position Held in Company:*

Telephone No.:*

Name of Escort:

Permit No.:

No. of days permit required for:*

Form A

Access Permits

Temporary Permits Permanent Permits

From Date:*

To Date:*

From Date:*

To Date:*

FALSE STATEMENTS MADE IN CONNECTION WITH THIS APPLICATION FOR A PORT ACCESS PERMIT BY THE APPLICANT, AUTHORISED SIGNATORY, OR ANYONE PROVIDING A REFERENCE FOR THE APPLICANT WILL RESULT IN AN OFFENCE UNDER THE CRIMINAL PROCEDURE ACT, 51 OF 1977. PLEASE NOTE THAT ALL APPLICANTS WILL BE SUBJECT TO A SCREENING PROCESS.

FAILURE BY THE APPLICANT AND/OR THE AUTHORISED SIGNATORY TO COMPLETE ANY PART OF THIS PORT ACCESS PERMIT APPLICATION FORM MAY RESULT IN THE DELAY AND/OR REFUSAL TO ISSUE A PORT ACCESS PERMIT. ANY QUERIES SHOULD BE DIRECTED TO THE PORT CUSTOMER SERVICES CENTRE / SECURITY PERMIT OFFICE AT 021 449 3111

APPLICANT PERSONAL DETAILS

(Applicants to present the original identity document/passport, together with certified copies thereof and valid work permits, business permits and/or visa (if applicable) to the Customer Services Centre or Security Permit Office.)

Surname: *

First Full Name :*

Initial :*

SA Citizen:*

Yes
No

ID Number/Passport Number:*

Contact Number:*

Gender:*

Male
Female

Home Address:*

Email address:*

Suburb:*

City:*

Postal Code:*

Country of Origin:*

Company:*

Department Manager:*

Company Telephone No.:*

Department:*

Company physical Address:*

Job Title:*

Employee No:*

Do you currently have a permit?:*

Yes
No
If Yes, Please provide reason for re-application:

Reason for re-Application:*

Port Induction Training:*

Yes
No

Date of Training:*

Do you have a criminal record:*

Yes
No

(If yes, Please provide Police Clearance Certificate (SAP ) )

(I, the Applicant, agree to adhere to all safety and security related rules and regulations imposed on all TNPA owned/managed areas in the Port. All particulars furnished by me on this Application Form are true and correct. )

Date of Application:*

VEHICLES DETAILS

(Please attach a copy of the Truck Registration documents e.g. RC1/LOC)

Add New

Vehicle Reg. No.*	Make*	Model *	Chassis or Vin No.*	Colour*	Action

CONFIRMATION OF EMPLOYMENT BY AUTHORISED SIGNATORY

(I / We hereby confirm the above Applicant’s employment at our Company. I / We undertake to return the Port Access Permit to the Customer Services Centre or Security Permit Office when said employee either ceases to be employed by us, or the Port Access Permit expires.)

Areas where access is required: *

Sub Areas where access is required: *

Areas where access is required: *

Sub Areas where access is required: *

Areas where access is required: *

Sub Areas where access is required: *

Areas where access is required: *

Sub Areas where access is required: *

Areas where access is required: *

Sub Areas where access is required: *

Areas where access is required: *

Sub Areas where access is required: *

Areas where access is required: *

Sub Areas where access is required: *

Areas where access is required: *

Sub Areas where access is required: *

Reason for Permit Application: *

Tools:*

Yes
No

Insert Details:*

Camera:*

Yes
No

Insert Details:*

Specialised equipment:*

Yes
No

Insert Details:*

Surname and initials of Authorised Signatory:*

Mobile:*

Email address:*

Form B

Access Permits

Temporary Permits Permanent Permits

From Date:*

To Date:*

From Date:*

To Date:*

CONTRACTORS ONLY

(TO BE COMPLETED BY CONTRACTOR COMPANY MANAGER)

Applicants to present the original identity document/passport, together with certified copies thereof and valid work permits, business permits and/or visa (if applicable) to the Customer Services Centre.

Name of Contractor Company for whom services are to be rendered: *

Department: *

Name of Contractor Company Manager:*

Telephone number :*

Name of Sub-Contractor Manager / Supervisor of Sub-Contractor Company:*

Telephone Number of Sub-Contractor Manager:*

List of employees requiring Port Access Permits

Add New

Name Of Employee*	ID Number / Passport Number / Permit Number *	Job Title *	Criminal Record(Yes/No)*	Signature Of Employee*	Action

CONFIRMATION OF EMPLOYMENT BY AUTHORISED SIGNATORY

I / We hereby confirm the above Applicant’s employment at our Company. I / We undertake to return the Port Access Permit to the Customer Services Centre when said employee either ceases to be employed by us, or the Port Access Permit expires.

Areas where access is required: *

Sub Areas where access is required: *

Reason for Permit Application: *

Tools:*

Yes
No

Insert Details:*

Camera:*

Yes
No

Insert Details:*

Specialised equipment:*

Yes
No

Insert Details:*

Surname and initials of Authorised Signatory:*

Telephone Work:*

Mobile:*

Identity Number:*

Email address:*

Signature of Authorised Signatory:*

Date:*

Upload Documents

Browse

Document Category	Document Name
		Delete

Security Code

sample text

Enter Security Code: *

Particulars of Resubmit Reverted Application

Port Entry Pass Application Number:*

Particulars of Resubmit Reverted Application

Application Form Number:

Remarks Provided By The PSO On Missing Information:

Particulars of Applicant

Port:*

Company Name:*

Department:*

Full Name of the Applicant:*

Surname of the Applicant:*

Pension/Employee No.:*

ID/Passport No.:*

Occupation:*

Email:*

Mobile No.:*

Home Address:*

Company Address:*

Company Telephone No.:*

Company Fax No.:*

Permit Requirements: (This Section is to be completed by the Sponsor Company / Authorized Signatory )

Permanent Permits

TPT Operated Terminals

NPA Sites

(Applicant to specify his/her specific place of work. Business Unit Manager/Line Manger to approve application where access to other NPA sites/Leaseholder Sites is required to perform job function)

Specific NPA Sites

Specify Name & Specific Location of Area/Site:

Private Terminals / Lease Holding Sites

Specify Name And Specific Location of Lease Holding Site:

Physical Address:

Permits

Temporary Permits Permanent Permits

Temporary Permits:

(This category applies to all individuals who are not permanently employed or based on NPA owned or managed by the Port)

Permanent Permits:

Yes No

Reason for Application:*

Particulars of Applicant

Port:*

Company Name:*

Department:*

Full Name of the Applicant:*

Surname of the Applicant:*

Pension/Employee No.:*

ID/Passport No.:*

Occupation:*

Email:*

Mobile No.:*

Home Address:*

Company Address:*

Company Telephone No.:*

Company Fax No.:*

Permit Requirements: (This Section is to be completed by the Sponsor Company / Authorized Signatory )

Permanent Permits

TPT Operated Terminals

NPA Sites

(Applicant to specify his/her specific place of work. Business Unit Manager/Line Manger to approve application where access to other NPA sites/Leaseholder Sites is required to perform job function)

Specific NPA Sites

Specify Name & Specific Location of Area/Site:

Private Terminals / Lease Holding Sites

Specify Name And Specific Location of Lease Holding Site:

Physical Address:

Contractor Information

Company Name:*

Contract No.:*

Name of Contract Manager/Supervisor:*

Duration of Contract:*

In Months

Name of Company for whom services are to be rendered: *

Name of Contract Manager responsible to monitor contract.:*

Contact Telephone No.:*

Mobile No.:*

Permits

Ad Hoc Permits Temporary Permits Contractors Permanent Permits

Ad Hoc Permits:

(Only for holders of permanent permits who have left their permits at home and are in possession of a valid ID document)

Temporary Permits:

(This category applies to all individuals who are not permanently employed or based on NPA owned or managed by the Port)

Contractors:

Indicate the Area of Construction

Permanent Permits:

Yes No

Reason for Application:*

Particulars of Applicant

Port:*

Company Name:*

Department:*

Full Name of the Applicant:*

Surname of the Applicant:*

Pension/Employee No.:*

Occupation :*

ID/Passport No.:*

Company Telephone No.:*

Company Fax No.:*

Email:*

Mobile No.:*

Company Address:*

Home Address:*

Vehicle Particulars

Vehicle Make:

Vehicle Registration No.:

Permit Requirements

Reason for Application

Reason for Application:*

Vehicle Particulars

Make:*

Model:*

Registration No.:*

Description of Truck:*

Is the Vehicle Registered in Company Name:*

Yes No

Is the Vehicle Painted In Company Colors or Have Clear Marking of Company on the Vehicle:*

Yes No

Detailed Reason to Substantiate for Issue of Vehicle Permit

Detailed Reason to Substantiate for Issue of Vehicle Permit:*

Company Related Information

Name of Company:*

Telephone No.:*

Company Fax No.:*

Company Address:*

Particulars of Company Representatives

Port:*

Name of the Applicant:*

Surname of the Applicant:*

Occupation:*

Residential Address:*

Department:*

Work Telephone No.:*

Pension/Employee No.:*

ID/Passport No.:*

Home Telephone No.:

Mobile No.:*

Email:*

Permit Requirements

If a Contractor State Contract No.:

Duration of Contract:

In Months

Temporary Permits:

Particulars of Applicant Requesting The Issue of A Visitors Permit

Port:*

Company Name:*

Department:*

Full Name:*

Occupation:*

ID/Passport No.:*

Email:*

Mobile No.:*

Company Address:*

Home Address:*

Company Fax No.:*

Company Telephone No.:*

Detailed Reason To Substantiate Application For Issue of Visitors Permit:*

Particulars of Applicant Requesting The Issue of A Visitors Permit

Company:*

Division/Section:*

Name of Authorized Person:*

Position Held in Company:*

Telephone No.:*

Name of Escort:

Permit No.:

No. of days permit required for:*

Form A

Access Permits

Temporary Permits Permanent Permits

From Date:*

To Date:*

From Date:*

To Date:*

APPLICANT PERSONAL DETAILS

Surname: *

First Full Name :*

Initial :*

SA Citizen:*

Yes
No

ID Number/Passport Number:*

Contact Number:*

Gender:*

Male
Female

Home Address:*

Email address:*

Suburb:*

City:*

Postal Code:*

Country of Origin:*

Company:*

Department Manager:*

Company Telephone No.:*

Department:*

Company physical Address:*

Job Title:*

Employee No:*

Do you currently have a permit?:*

Yes
No
If Yes, Please provide reason for re-application:

Reason for re-Application:*

Port Induction Training:*

Yes
No

Date of Training:*

Do you have a criminal record:*

Yes
No

(If yes, Please provide Police Clearance Certificate (SAP ) )

Date of Application:*

VEHICLES DETAILS

(Please attach a copy of the Truck Registration documents e.g. RC1/LOC)

Add New

Vehicle Reg. No.*	Make*	Model *	Chassis or Vin No.*	Colour*	Action

CONFIRMATION OF EMPLOYMENT BY AUTHORISED SIGNATORY

Areas where access is required: *

Sub Areas where access is required: *

Reason for Permit Application: *

Tools:

Yes
No

Insert Details:*

Camera:

Yes
No

Insert Details:*

Specialised equipment:

Yes
No

Insert Details:*

Surname and initials of Authorised Signatory:*

Mobile:*

Email address:*

Form B

Access Permits

Temporary Permits Permanent Permits

From Date:*

To Date:*

From Date:*

To Date:*

CONTRACTORS ONLY

(TO BE COMPLETED BY CONTRACTOR COMPANY MANAGER)

Name of Contractor Company for whom services are to be rendered: *

Department: *

Name of Contractor Company Manager:*

Telephone number :*

Name of Sub-Contractor Manager / Supervisor of Sub-Contractor Company:*

Telephone Number of Sub-Contractor Manager:*

List of employees requiring Port Access Permits

Add New

Name Of Employee*	ID Number / Passport Number / Permit Number *	Job Title *	Criminal Record(Yes/No)*	Signature Of Employee*	Action

CONFIRMATION OF EMPLOYMENT BY AUTHORISED SIGNATORY

Areas where access is required: *

Sub Areas where access is required: *

Reason for Permit Application: *

Tools:

Yes
No

Insert Details:*

Camera:

Yes
No

Insert Details:*

Specialised equipment:

Yes

Insert Details:*

Surname and initials of Authorised Signatory:*

Telephone Work:*

Mobile:*

Identity Number:*

Email address:*

Signature of Authorised Signatory:*

Date:*

Upload Documents

Browse

Document Category	Document Name
		Delete

Security Code

sample text

Enter Security Code: *

Particulars of Appeal On Rejected Application

Rejected Port Entry Pass Application Number:

PSO Rejected Remarks:

Application Form No.:

PSO Rejected Remarks:

Particulars of Applicant

Port:

Company Name:

Department:

Full Name of the Applicant:

Surname of the Applicant:

Pension/Employee No.:

ID/Passport No.:

Occupation:

Email:

Mobile No.:

Home Address:

Company Address:

Company Telephone No.:

Company Fax No.:

Permit Requirements: (This Section is to be completed by the Sponsor Company / Authorized Signatory )

Permanent Permits

TPT Operated Terminals

NPA Sites

(Applicant to specify his/her specific place of work. Business Unit Manager/Line Manger to approve application where access to other NPA sites/Leaseholder Sites is required to perform job function)

Specific NPA Sites

Specify Name & Specific Location of Area/Site:

Private Terminals / Lease Holding Sites

Specify Name And Specific Location of Lease Holding Site:

Physical Address:

Permits

Temporary Permits Permanent Permits

Temporary Permits:

(This category applies to all individuals who are not permanently employed or based on NPA owned or managed by the Port)

Permanent Permits:

Yes No

Reason for Application:*

Particulars of Applicant

Port:

Company Name:

Department:

Full Name of the Applicant:

Surname of the Applicant:

Pension/Employee No.:

ID/Passport No.:

Occupation:

Email:

Mobile No.:

Home Address:

Company Address:

Company Telephone No.:

Company Fax No.:

Permit Requirements: (This Section is to be completed by the Sponsor Company / Authorized Signatory )

Permanent Permits

TPT Operated Terminals

NPA Sites

(Applicant to specify his/her specific place of work. Business Unit Manager/Line Manger to approve application where access to other NPA sites/Leaseholder Sites is required to perform job function)

Specific NPA Sites

Specify Name & Specific Location of Area/Site:

Private Terminals / Lease Holding Sites

Specify Name And Specific Location of Lease Holding Site:

Physical Address:

Contractor Information

Company Name:

Contract No.:

Name of Contract Manager/Supervisor:

Duration of Contract:

In Months

Name of Company for whom services are to be rendered:

Name of Contract Manager responsible to monitor contract.:

Contact Telephone No.:

Mobile No.:

Permits

Ad Hoc Permits Temporary Permits Contractors Permanent Permits

Ad Hoc Permits:

(Only for holders of permanent permits who have left their permits at home and are in possession of a valid ID document)

Temporary Permits:

(This category applies to all individuals who are not permanently employed or based on NPA owned or managed by the Port)

Contractors:

Indicate the Area of Construction

Permanent Permits:

Yes No

Reason for Application:*

Particulars of Applicant

Port:*

Company Name:*

Department:*

Full Name of the Applicant:*

Surname of the Applicant:*

Pension/Employee No.:*

Occupation :*

ID/Passport No.:*

Company Telephone No.:*

Company Fax No.:*

Email:*

Mobile No.:*

Company Address:*

Home Address:*

Vehicle Particulars

Vehicle Make:

Vehicle Registration No.:

Permit Requirements

Reason for Application

Reason for Application:*

Vehicle Particulars

Make:

Model:

Registration No.:

Description of Truck:

Is the Vehicle Registered in Company Name:

Yes No

Is the Vehicle Painted In Company Colors or Have Clear Marking of Company on the Vehicle:

Yes No

Detailed Reason to Substantiate for Issue of Vehicle Permit

Detailed Reason to Substantiate for Issue of Vehicle Permit:*

Company Related Information

Name of Company:*

Telephone No.:*

Company Fax No.:*

Company Address:*

Particulars of Company Representatives

Port:*

Name of the Applicant:*

Surname of the Applicant:*

Occupation:*

Residential Address:*

Department:*

Work Telephone No.:*

Pension/Employee No.:*

ID/Passport No.:*

Home Telephone No.:

Mobile No.:*

Email:*

Permit Requirements

If a Contractor State Contract No.:

Duration of Contract:

In Months

Temporary Permits:

Particulars of Applicant Requesting The Issue of A Visitors Permit

Port:

Company Name:

Department:

Full Name:

Occupation:

Email:

Mobile No.:

ID/Passport No.:

Company Address:

Home Address:

Company Fax No.:

Company Telephone No.:

Detailed Reason To Substantiate Application For Issue of Visitors Permit:*

Particulars of Applicant Requesting The Issue of A Visitors Permit

Company:

Division/Section:

Name of Authorized Person:

Position Held in Company:

Telephone No.:

Name of Escort:

Permit No.:

No. of days permit required for:

Form A

Access Permits

Temporary Permits Permanent Permits

From Date:*

To Date:*

From Date:*

To Date:*

APPLICANT PERSONAL DETAILS

Surname: *

First Full Name :*

Initial :*

SA Citizen:*

Yes
No

ID Number/Passport Number:*

Contact Number:*

Gender:*

Male
Female

Home Address:*

Email address:*

Suburb:*

City:*

Postal Code:*

Country of Origin:*

Company:*

Department Manager:*

Company Telephone No.:*

Department:*

Company physical Address:*

Job Title:*

Employee No:*

Do you currently have a permit?:*

Yes
No
If Yes, Please provide reason for re-application:

Reason for re-Application:*

Port Induction Training:*

Yes
No

Date of Training:*

Do you have a criminal record:*

Yes
No

(If yes, Please provide Police Clearance Certificate (SAP ) )

Date of Application:*

VEHICLES DETAILS

(Please attach a copy of the Truck Registration documents e.g. RC1/LOC)

Add New

Vehicle Reg. No.*	Make*	Model *	Chassis or Vin No.*	Colour*	Action

CONFIRMATION OF EMPLOYMENT BY AUTHORISED SIGNATORY

Areas where access is required: *

Sub Areas where access is required: *

Reason for Permit Application: *

Tools:

Yes
No

Insert Details:*

Camera:

Yes
No

Insert Details:*

Specialised equipment:

Yes
No

Insert Details:*

Surname and initials of Authorised Signatory:*

Mobile:*

Email address:*

Form B

Access Permits

Temporary Permits Permanent Permits

From Date:*

To Date:*

From Date:*

To Date:*

CONTRACTORS ONLY

(TO BE COMPLETED BY CONTRACTOR COMPANY MANAGER)

Name of Contractor Company for whom services are to be rendered: *

Department: *

Name of Contractor Company Manager:*

Telephone number :*

Name of Sub-Contractor Manager / Supervisor of Sub-Contractor Company:*

Telephone Number of Sub-Contractor Manager:*

List of employees requiring Port Access Permits

Add New

Name Of Employee*	ID Number / Passport Number / Permit Number *	Job Title *	Criminal Record(Yes/No)*	Signature Of Employee*	Action

CONFIRMATION OF EMPLOYMENT BY AUTHORISED SIGNATORY

Areas where access is required: *

Sub Areas where access is required: *

Reason for Permit Application: *

Tools:

Yes
No

Insert Details:*

Camera:

Yes
No

Insert Details:*

Specialised equipment:

Yes

Insert Details:*

Surname and initials of Authorised Signatory:*

Telephone Work:*

Mobile:*

Identity Number:*

Email address:*

Signature of Authorised Signatory:*

Date:*

Reason to substantial Appeal Application of Permit Application:

Detailed Reason to substantial Appeal Application of reissue of Permit Application:*

Upload Documents

Browse

Document Category	Document Name
		Delete

Security Code

sample text

Enter Security Code: *