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ACKNOWLEDGEMENT OF DEBT
Complete this document in accordance with the guidelines set out
in this column. Please ensure that all information requested is in
square brackets is supplied.

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1. I, ____________________________________________________(insert name), an adult, with Student No.
_______________________, acknowledge that:

Please provide the persons full name and Student Number
Initial
DO NOT LEAVE ANY PORTION OF THIS BLANK

a. I am liable to the University of the Witwatersrand, Johannesburg (“the University”) in
the amount of R________________________ (“the Principle Debt”);

Please provide the accurate figure
Initial
DO NOT LEAVE THIS BLANK
Initial

b. Subject to clause (c) below, the Principal Debt is due and payable immediately upon
signature of this Agreement; and
Initial
c. By signing this Agreement I am entering into