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

In the matter between

............................................................................................... Judgment Creditor

and

............................................................................................... Judgment Debtor

To: ......................................................................................... (Name)

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

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

............................................................................................... (Residential address)

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

............................................................................................... (Occupation/Status)

You are hereby required to appear before the court at ..................................... (place) on .................. (date) at .................. (time) to enable the court to inquire into your/the juristic person's financial position in terms of section 65D of the Act.

Notice:

Should you wilfully fail to appear before the said court on the said date and at the said time, or fail to remain present at the proceedings concerned, you will be guilty of an offence and liable on conviction to a fine or to imprisonment for a period not exceeding three months. [Section 65A(9) of the Act]

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

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

Sheriff of ...............................................................

CERTIFICATE

I, ................................................ Sheriff/Deputy Sheriff of ........................................ hereby certify that I have handed the original of this notice to ..................................... and that I have explained to him or her the import hereof.

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

Sheriff of ...............................................................

Duplicate original to the

Registrar/Clerk of the Court ..............................................