Form H

NOTICE TO PUBLIC PROSECUTOR OF INTENTION TO INSTITUTE PRIVATE PROSECUTION

NOTICE IN TERMS OF SECTION 23(5)(b) OF THE EXTENSION OF SECURITY OF TENURE ACT, 1997

[Where service of this notice is effected by hand, an additional copy of the notice must be prepared. Such copy shall be signed and dated by the person receiving it and returned to the person serving the notice as proof of service.]

The Public Prosecutor

_____________________________

_____________________________

_____________________________

_____________________________

[Fill in name and address of public prosecutor]

Please take note that I/we, the undersigned ______________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

[fill in the names of the persons whose rights or interests have been prejudiced by the alleged offence]

am/are considering instituting a private prosecution against

______________________________________________________________________________________

[give full names of alleged offenders] in terms of section 23(4) of the Extension of Security of Tenure Act (Act No. 62 of 1997)].

The alleged offence to which this notice relates is as follows:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

[Give full details of the events surrounding the alleged unlawful eviction.]

The land to which this notice relates is:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

[Give the physical address and the full Deeds Office description of the land on which the alleged unlawful eviction took place. In the case of a farm, this must include the portion, name and number of the farm, and the name of the district in which the farm is situated.]

If, within 14 days of receiving this notice you have not communicated to me/us in writing that you mend prosecuting this matter yourself, I/we intend instructing ___________________________ [give full names of attorney/advocate] to institute a private prosecution on my/our behalf.

Your attention is drawn to section 23(5) of the Extension of Security of Tenure Act, 1997 (Act No. 62 of 1997).

Signed at _________________________ on this the ______ day of _____________________________

[Fill in the name of the district or closest town or city and today's date]

[Signature/s of persons issuing this notice.]

Full name/s:

Return address:

_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________

[The return address may be the address of a legal representative.]

Contact person: __________________________________________

Tel. No _________________________________________________

Fax No. _________________________________________________

Received by me on this the _______ day of _____________________________ at _____h_____

[Fill in the name of the district or closest town or city, today's date and the time when the notice was served.]

_____________________________________________

[Signature of public prosecutor or person apparently authorised to act on his or her behalf.]