KNOW ALL MEN WHOM IT MAY CONCERN

THAT, whereas on the ..............................................day of .......................... 20 ..................

THE NATIONAL DEVELOPMENT BANK OF BOTSWANA

(hereinafter referred to as the BANK)

and

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

(hereinafter referred to as the FARMER

residing at ........................................................... and of postal address ..............................

........................................................................................................ and whose date of birth

or, if this is not known, whose approximate age is .................................................................. concluded an agreement in terms of which the FARMER is indebted to the BANK in certain sums of money, and in terms of which agreement it was agreed that the Agricultural Charges Act would apply to the said agreement.

NOW THEREFORE the BANK acting through its authorised agent and the FARMER do hereby certify as correct a certificate of indebtedness as referred to in section 4 of the Act as follows-

1.    The full names, place of residence, postal address and date of birth or approximate age of the said farmer are as set out above.

2.    The place of signature of the certificate is ......................................................................

3.    It is hereby acknowledged that the BANK has through its agent

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

explained fully to THE FARMER the legal effect of making the said agreement subject to provisions of the said Act, and the FARMER hereby acknowledges himself to have fully understood the explanation and the legal effect of the said agreement being subject to the provisions of the said Act.

4.    It is hereby certified by the PARTIES and acknowledged by the FARMER, that in terms of the said agreement that the FARMER

is indebted to the BANK in the sum of P ........................................................ plus interest at ......... % repayable in equal instalments, including interest, over a period of ................................................................. years as set out below—