ACKNOWLEDGMENT OF RIGHT TO ARREARS OF LICENCE FEES UNDER A LICENCE 

I, ____________________________,

S/o Mr. ____________________,

 Resi____________________________________________________

hereby acknowledge that I owe to Mr ________________________________________, Mr.____________________________________,

Resi________________________________________________________________________________ as arrears of licence fees from ____________

 to _________

 under a Licence dated _____________

 in respect of the………………………………..…………….

 situated at __________. 

Dated:________ 

(Signed)_____________ 

Address:____________ 

[There are several forms in which an acknowledgment may be made by way of a mere receipt or an agreement. Where there is any question relating to any right in immovable property, suitable form may be adapted.]