640

THE HONGKONG GOVERNMENT GAZETTE, DECEMBER 24,

Ship's Stores.

No. of cases or other articles.

Description of cases or other articles.

Contents.

This statement is also furnished as the import manifest under

the Certificates of Origin Ordinance, 1915.

Dated the................................day of....

...191......

Owners, Agents or Charterers,

(Address.)

(Additional personal signature if the above name be that of a body corporate or firm or association or organisation.)

FORM No. 8.

[Rule 27.]

EXPORT STAtement.

(Importation and Exportation Ordinance, 1915.)

I (we) hereby declare that the following articles were exported

by the S.S..

......which left the Colony

for........

..on.

No. of cases or other

articles.

Description of cases or other articles.

Cargo.

Weight Con-

Con- Con-

Port of

Marks. No. or Quan- tents. signor.signee. destination.

tity.

1915.

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