I,

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

Being the/acting as

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

designated as contemplated in regulation 2 of the Prevention of Organised Crime Regulations,

1991, hereby acknowledge receipt of the following report(s):

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

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

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

Made in terms of section 7 of the Prevention of Organised Crime Act, 1998 (Act 121 of 1998),

by ........................................................................................................... in his / her capacity as

............................................ of ................................ on ................................................

I also acknowledge receipt of copies of the following documentation which accompanied the

report(s):

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

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

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

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

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

Signed at ........................................... this ...................... day of .................................

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

(Signature of person making the report)