SCHEDULE A

FORM B

Prepared by me

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(Signature)

CONVEYANCER

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(State surname and initials in block letters.)

CERTIFICATE OF REGISTERED TITLE NO CRT

(Issued under the provisions of section 24 of the Mining Titles Registration Amendment Act, 1967)

WHEREAS .............................................. and ....................................... are joint holders of the under mentioned right by virtue of .......................................................................................................................//........

AND WHEREAS …………………………………………………………………………………….. has applied for a certificate of registered title under the provisions of section 24(2) and (5) of the Mining Titles Registration Act, in respect of the share therein held by him or her.

AND whereas the provisions of this Act have been complied with.

NOW THEREFORE in pursuance of the provisions of the said Act, I, the Director-General, do hereby certify  that the said ........................................................................................, is the registered holder of:—

CERTAIN (describe the right and the share held therein) .............................................. situate on the farm, .......................................................... in ................................... Region and defined by diagram/plan No. …....................... and held under DT/ CRT No ........................ dated ............

(Where the right is subject to special conditions the Director-General may in his or her discretion require such special conditions to be set out in this certificate or he or she may permit a notarially certified copy of the document of the evidencing such special conditions to be annexed to each copy of this certificate and in the latter event a reference to the said copy so annexed should be made in this certificate).

Wherefore all the right, title and interest which the transferor heretofore had to the right aforesaid is renounced, and in consequence it is also acknowledged that the transferor is entirely dispossessed of, and disentitled to, the same, and that, by virtue of these presents the aforesaid transferee now is entitled thereto, the State however, reserving its rights.

Signed, executed and sealed at the Mineral and Petroleum Titles Registration Office at Pretoria on this ............ day of ........................... 20 ......................

DIRECTOR-GENERAL: MINERALS AND ENERGY

Registered on the above date in the Register of Certificates of Registered Titles under CRT

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