522
THE HONGKONG GOVERNMENT GAZETTE, 4îи OCTOBER, 1873.
Form of Colonial Treasurer's Certificate under Section 18
Nature and Particulars of Claims for Crown Rent.
4
5
1
2
3
Nane of Defendant.
Amount Claimed.
No. of Crown Lot in respect of which the Rent is claimed. Term of Lease.
Whether Defendant is Original Lessee or Assignee in pos- session by Purchase or Mortgage.
For what Period the Rent Claimed and when due.
Nature and Particulars of Claims for Police, Lighting, Water, and Fire Brigade Rates.
1
2
3
4
5
Name of Defendant.
Amount Claimed.
No. of Tenement in respect of which Rates Payable.
Whether Defendant is Owner or Occupier.
For whet Period Rates Claimed and when due.
I
Nature and Particulars of Claims for Spirit License Fees.
2
3
4
5
Name of Defendant.
Amount Clained,
Number, Date and Period of License.
Whether
original Licensee or Transferrec of License.
For what Period, and whether entire Fre or Instalment, and when due.
I hereby certify that the several Persons whose Names are entered in the First Column of the above Schedule have made default in the Payment to the Crown of the Sums appearing opposite to thicir respective Names in the Second Column, and that the said Persons are severally liable to the Payment thereof in respect of the Claims, the Nature and Particulars of which are truly set forth opposite their respective Names in the Third, Fourth, and Fifth Columns.
or (in Suits for Crown Rent,)
I, A.B., Colonial Treasurer of Hongkong, do hereby certify that the several Persons whose Names are entered in the First Column of the above Schedule have made Default in the Payment of the Sums appearing opposite to their re- spective Names in the Second Column, in respect of the Crown Rent, and I, A.B., Surveyor General, do hereby certify that the Particulars of the above Claims for Crown Rent against such Persons are truly set forth opposite their respective Names in the Third, Fourth, and Fifth Columns.
Dated the.
C
.187
Colonial Treasurer.
Surveyor General.