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FORM C OBJECTION NO: The Municipal Manager Alfred Duma Local Municipality LODGING OF AN OBJECTION AGAINST A MATTER REFLECTED IN OR OMMITTED FROM THE VALUATION ROLL / SUPPLEMENTARY VALUATION ROLL FOR THE PERIOD 1 JULY 2017 TO 30 JUNE 2021 (COMPLETE A SEPARATE FORM FOR EACH ENTRY OBJECTED TO) HOLDING/PORTION NO: SECTION 1: OBJECTOR INFORMATION AGRICULTURAL HOLDING/FARM: FARM NO: REG DIV: 1.1 OBJECTOR IS THE OWNER Registered Owner of Property: Identity No: Physical Address of Owner: Postal Address of Owner: Company/C.C. Registration No: Telephone No: Home ( ) Work: ( ) 1.2 OBJECTOR IS NOT THE OWNER OR MUNICIPALITY IS THE OBJECTOR Name of Objector: Identity No: Physical Address of Objector: Postal Address of Objector: Company/C.C. Registration No: Telephone No: Home ( ) Work: ( ) Status of Objector (e.g. Tenant, Pending Purchaser, Municipality, etc.) Complete: Portion/Holding No: Farm/Holding:. Page 1 of 6

1.3 AUTHORISED REPRESENTATIVE OF THE OBJECTOR Name of Representative: Postal Address: Telephone No: Home ( ) Work: ( ) * If a Representative is appointed, proof of authorisation must be attached SECTION 2: PROPERTY DETAILS (For Sectional Titles see Section 4) Physical Address: Extent of Property: m² Municipal Account No: (if available) Name of Bond Holder: Registered amount of Bond: (if applicable) (if applicable) Provide Full Details of All Servitudes, Road Proclamations or Other Endorsements Servitude No: Affected Area: m² In Favour of: For what Purpose: Was Compensation Paid? (If Yes) Date of Payment: Amount: R Complete: Portion/Holding No: Farm/Holding:. Page 2 of 6

SECTION 3: DESCRIPTION OF RESIDENTIAL DWELLING (For Sectional Titles see Section 4) Indicate Quantity and Complete Description of Other if applicable 3.1 MAIN DWELLING ON FARM/HOLDING: Bedrooms Bathrooms Kitchen Lounge Lounge with Dinning Room Dinning Room Study Playroom Television Room Laundry Separate Toilet Other Other Size of Main Dwelling: m² 3.2 OTHER BUILDINGS: (Attach Annexure) Building No. Description Size m² Condition Is Building Functional 3.3 Is Any Portion of the Property Used for Any Other Purpose Other than Agricultural? If Yes Describe Use/s: 3.4 LAND USE ANALYSIS: If necessary provide Annexure B Non Agricultural (Refer to 3.3): ha Condition of Fences: Grazing: ha Under Irrigation: ha Area Game-Fenced: ha Dry Land: ha ha Permanent Crops: ha No of Boreholes: Other: ha Output l /hour: l Other: ha No of Dams: Other: ha Dam/s Capacity: Other: ha TOTAL ha Is Property Exposed to a River? Complete: Portion/Holding No: Farm/Holding:. Page 3 of 6

3.5 LAND USE ANALYSIS: Is your Property affected by a Land Claim? If Yes: - Date of Claim: Gazette No. Do you have Water Rights? If Yes: Details - Have you applied for a Rezoning or Consent Use? (e.g. Guest House, Business) If Yes: Details - Has your Agricultural Holding been Excised? If Yes: New Farm Description - Has the Township been Applied for or Proclaimed? If Yes: Full Details - Tenant and Rent Information ANNEXURE C: Name of Tenant Size Rental (excl. VAT) Escalation of Rental Other Contributions Term of Lease Start Date SECTION 4: MARKET INFORMATION If your Property is currently on the market, what is the Asking Price? R If your property has been on the market in the last 3 years, what was the Asking Price? R Offers Received: R Offers Received: R Name of Agent: Tel: Sale Transactions (of Other Property in the vicinity) used by the Objector in determining the Market Value of Property Objected to: HOLDING NO: AGRICULTURAL HOLDING/FARM: DATE OF SALE: SELLING PRICE: Complete: Portion/Holding No: Farm/Holding:. Page 4 of 6

SECTION 5: OBJECTION DETAILS PARTICULARS AS REFLECTED IN THE VALUATION ROLL CHANGES REQUESTED BY OBJECTOR Description of Property: Category: Physical Address: Extent: Market Value: Name of Owner: Adverse features and/or further reasons in support of this objection (Annexure can be provided). FORM A: RESIDENTIAL (FULL TITLE AND SECTIONAL TITLE USED FOR RESIDENTIAL PURPOSES) SECTION 7: DECLARATION Attention is hereby drawn to section 42(2) of the Act which states that where any document, information or particulars were not provided when required in terms of Subsection 42 (1) of the Act and the owner concerned relies on such document, information or particulars in an appeal to an Appeal Board, the Appeal Board may make an order as to costs in terms of Section 70 of the Act if the Appeal Board is of the view that failure to have provided any such document, information or particulars has placed an unnecessary burden on the functions of the Municipal Valuer of the Appeal Board. I / We (FULL NAME) Information and particulars supplied are true and correct. hereby declare that the Signed at on the Date: 20 / / YYYY MM DD SIGNATURE Complete: Portion/Holding No: Farm/Holding:. Page 5 of 6

OFFICIAL USE SECTION 8: DECISION OF MUNICIPAL VALUER Description of Property: Category: Physical Address: Extent: Market Value: Name of Owner: Reasons of the Municipal Valuer: / / *Name of Municipal/Assistant Municipal Valuer *Delete whichever is not applicable Signature YYYY MM DD SECTION 9: DECISION OF MUNICIPAL VALUER SIGNATURE DATE Valuation Roll Adjusted Objector Notified Owner Notified Section 52(1)(a) Where applicable Complete: Portion/Holding No: Farm/Holding:. Page 6 of 6