[Section 69(2) of Act 32 of 1944]

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

To the Sheriff of the Court.

Whereas .......................................... of ........................................ has interpleaded in this court as to ..................................................... (state subject matter) which is adversely claimed by ............................ of ..................................... and .............................. of .............................. hereinafter called the claimants;

Summon the said claimants that they appear before the above-mentioned court on the ................................ day of ................................20..., at ............... (time), and that they do then severally state the nature and particulars of their several claims and whether they will maintain or relinquish the same.

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

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

Registrar/Clerk of the Court.