A notice to a licensee to pay a levy imposed under section 169 (1) of the Act is prescribed for the purposes of section 169 (4) of the Act if the notice is signed by the Secretary and contains the following particulars--
(a) the amount of the levy payable by the licensee,
(b) the date by which and the manner in which the amount of the levy is payable,
(c) a note, in terms of section 169 (4) of the Act, as to the consequences of a failure by a licensee to pay the levy,
(d) the date on which the notice was signed by the Secretary.