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

In the matter between

..................................................................................................................... Execution Creditor

and

...................................................................................................................... Execution Debtor

To: ................................................................................................................ Execution Debtor.

Take notice that I have this day laid under judicial attachment the property comprised in the above inventory in pursuance of a warrant directed to me under the hand of the registrar or clerk of the court for the district or region of ......................................, whereby I am required to cause to be raised of your property in this district or region the sum of R............. and R............ costs recovered against you by the judgment of the said court in this action and my charges in respect of the said warrant.

Dated at .................................. this ................................... day of ..................................., 20......

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

Sheriff.