IN THE MAGISTRATE’S COURT FOR THE DISTRICT/REGION OF  HELD AT

CASE NO:

In the matter of:

…………………….......................................................................... Applicant

TAKE NOTICE that application will be made on behalf of the above-named applicant on the ........................... day of ................................................ at 9:00 or as soon thereafter as counsel may be heard for an order in the following terms:

(a) ......................................................................................................

(b) ......................................................................................................

(c) ......................................................................................................

and that the affidavit of ................... annexed hereto will be used in support thereof.

Kindly place the matter on the roll for hearing accordingly.

DATED at .............................................................

............................................................................

Applicant/Applicant's Attorney

…………………………………………………........................…..

To the Registrar/Clerk of the above-named Court.