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

HELD AT

CASE NO: .....................

In the matter between:

Plaintiff

and

Defendant

To:

A .................................................... B ............................................(sex) ........................................(occupation) formerly residing at ............................................................................, but whose present whereabouts are unknown:

TAKE NOTICE that by summons sued out of this court, you have been called upon to give notice, within ............ days after publication hereof, to the registrar/clerk of this court and to the plaintiff/plaintiff's attorney of your intention to defend (if any) in an action wherein

C ....................................................... D .............................................claims:

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

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

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

TAKE NOTICE FURTHER that if you fail to give such notice, judgment may be granted against you without further reference to you.

DATED at ...................................... this ..............................day of .............20......

Plaintiff/Plaintiff's Attorney

Address for service:

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

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

Registrar/Clerk of the Court