Form C.

To [Name in full]. Take notice that Mr. has reported that you have not fulfilled the Condition No. 1 of your license to occupy land in Block dated . If you are dissatisfied with the report, you may within thirty days after this notice shall be posted, appeal to any Resident Magistrate holding a Court near the land mentioned in your license, by delivering to him the notice a form whereof is annexed, properly tilled up by you [Form D to be annexed] and paying him five pounds, which will be returned to you if your appeal is successful.