FORM C
ATTESTATION WITH RESPECT TO SEIZED ARTICLES
I,
(name), attest on penalty of
criminal punishment for false statement or attestation that my position with the Government of
(country) is
received custody of the articles listed below from
(name of person) on
(date), at
(title). I
(place). I relinquished
(date), at
custody of the articles listed below to (Name of Person) on
(place) in the same condition as when
I received them (or, if difference, as noted below).
Description of Articles:
Changes in condition while in my custody:
Official Seal
(Signature)
(Place)
(Title)
(Date)
DRAFT U.S.-HONG KONG MLAT TEXT, NOVEMBER 22, 1988