In the Magistrate's Court for the District/Region of ........................................................  held at ......................................... Case No. ........................................ of 20.........

In the matter between

..................................................................................................................... Plaintiff

and

................................................................................................................. Defendant

Sir/Madam,

You are hereby summoned to attend and serve as an assessor in this court on the ..................... day of ............................, 20....... at ..................... (time), to assist the court in the above action in accordance with the provisions of section 34 of the Magistrates' Courts Act, 1944 (Act 32 of 1944).

Yours faithfully

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

Registrar/Clerk of the Court

To:        ...........................................................................

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

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