IFani : ... 
Amagama apheleleyo: ... 
Inombolo yesazisi: ... 
Umbutho wezopolitiko/iziko/iqumrhu/umbutho wenkululeko:
Isikhundla kumbutho/iziko/iqumrhu/umbutho wenkululeko:
Idilesi yesitalato ye-ofisi eyintloko yombutho/iziko/iqumrhu/umbutho wenkululeko:
Idilesi yePosi:
Inombolo yomNxeba: ( ... ) ... 
ISIQINISEKISO ESIGCWALISWA NGUMBUTHO WEZOPOLITIKO/IZIKO/IQUMRHU/UMBUTHO WENKULULEKO
ISAZISO ESIBALULEKILEYO: UKWENZIWA KWENGXELO ENGASIYONYANI LITYALA LOLWAPHULO-MTHETHO
ISIBHENGEZO
Mna ... (amagama apheleleyo) ngenxa yoko ndibhengeza egameni le ... (igama lombutho/iziko/iqumrhu/umbutho wenkululeko) ukuba u ... (amagama apheleleyo omfaki sicelo) wayelilungu lalo mbutho/iziko/iqumrhu/umbutho wenkululeko ukhankanywe ngasentla xa i(ama)tyala elifunelwa uxolelo njengoko kuxeliwe kumhlathi wesi-2 wefom yesicelo, laye/aye enziwa, kwaye i(ama)tyala lenziwa ukuze kuphunyezwe ezi njongo zezopolitiko zilandelayo zombutho/iziko/iqumrhu/umbutho wenkululeko ngexesha le(lama)tyala:
Ndiluqinisekisile olu lwazi lukhankanywe ngasentla ngale ndlela ilandelayo umzekelo ngokufumana ulwazi oluvela kwi-database/ngokufumana iingxelo ezivela kula mangqina alandelayo, ndinolwazi buqu ngesehlo njl. njl. amagama, iidilesi neenombolo zeminxeba zamangqina kufuneka zinikwe:
Umbutho/iziko/iqumrhu/umbutho wenkululeko wam, unoluvo lokuba kuya kuba kokulungileyo u ... (amagama apheleleyo omfaki sicelo) uyaxolelwa ngezi zizathu zilandelayo:
Umbutho/iziko/iqumrhu/umbutho wenkululeko wam nawo unoluvo lokuba
 ... (amagama apheleleyo omfaki sicelo) ngeke abe saba sisoyikiso okanye ingozi eluntwini ngezi zizathu zilandelayo:
Ndigunyaziswe ngumbutho/iziko/iqumrhu/umbutho wenkululeko ukuba ndenze le ngxelo kwaye ndinike esi siqinisekiso egameni lo mbutho.
Esi sigaba masigcwaliswe kwaye iphepha ngalinye kufakwe oonobumba kulo kukho uMgwebi wamaTyala amaNcinane eNkundleni okanye uMkomishinala oFungisayo
Mna ... 
Amagama apheleleyo nefani ndibhengeza ukuba olu lwazi lungasentla luyinene kwaye luchanekile.
Ingaba uyakwazi kwaye ukuqonda okuqulethwe yile ngxelo?
Impendulo: ... 
Ingaba unayo nayiphi na inkcaso echasene nokuthatha isifungo esimiselweyo?
Impendulo: ... 
Ingaba isifungo esimiselweyo usithatha njengesibophelelayo kwisazela sakho?
Impendulo: ... 
A. Ndiqinisekisa ukuba imibuzo ekhankanywe ngasentla ithiwe thaca kum kwaye iimpendulo zayo ke apho njengoko ziboniswe ngasentla zibhalwe ndikhona.
B. Ndiqinisekisa ukuba umbhengezi uvumile ukuba uyakwazi kwaye ekuqonda okuqulethwe kwesi sibhengezo esifungelwe phambi kwam kwaye usayino lombhengezi ke apho luye lwabekwa ndikhona.
UMgwebi wamaTyala amaNcinane eNkundleni
UMkomishinala oFungisayo
NgoonoBumba abakhulu
IDilesi yaseMsebenzini ... 
Umhla ... Indawo ... 
OKANYE
Impendulo ... 
A. Ndiqinisekisa ukuba umbuzo okhankanywe ngasentla uthiwe thaca kum kwaye impendulo yam apho ke njengoko ibonisiwe ngasentla ibhalwe phantsi ndikhona.
B. Ndiqinisekisa ukuba umbhengezi uvumile ukuba uyakwazi kwaye ekuqonda okuqulethwe kwesi sibhengezo siqinisekiswe phambi kwam kwaye usayino lombhengezi ke apho luye lwabekwa ndikhona.
UMgwebi wamaTyala amaNcinane eNkundleni
UMkomishinala oFungisayo
NgoonoBumba abakhulu
IDilesi yaseMsebenzini ... 
Umhla ... Indawo ... 
