(*Note: insert "No change" where furnished particulars remain
unchanged.)
I certify that the above particulars and my description
are correct.
2.
Fee: $
Note:
(i)
(ii)
enclosed.
Signature
of informant
Description
of informant
Date
(proprietor or otherwise)
This form must be completed in duplicate.
Use Form 3 for notifying the Registrar of
Newspapers of any change of proprietor of a
local newspaper.