Go with cursor inside the box below and click anywhere, copy/paste this form into your word processor. Print this form, complete it by hand, scan back into the computer and email as an attachment to rudi@smsad.co.za. This form is to speed up registration and verification with Google Places.

GOOGLE PLACES PLACEMENT 73 Geelhout Avenue Vastfontein Pretoria P.O.Box 232, Montana Park, 0159 Tel: 083 525 3892 Email: rudi@smsad.co.za   Date: …..…..…. Ref: Gerald P.     I, …………………………………………………….. am the owner/authorized person of   the following company: ………………………………………………………………….   at the following address: …………………………………………………………………   …………………………………………………………………………………………………….   With the following telephone numbers (The underlined number is used for verification   …………………………………………………………………………………………………………..   …………………………………………………………………………………………………………..   The business is doing the following: ……………………………………………………….   I hereby give Mr. Rudi Man in ‘t Veld permission to place my business on Google Places and keep it up to date.   This letter is only to be used for verification purposes by Google   Signed by:………………………………………….   Date: ………………………………………………..   Signature: …………………………………………   This form to be emailed to rudi@smsad.co.za