LIQUORS CONSOLIDATION.

No. 9 of 1911.

1907

4. Have you any disability or disorder which impedes the free use of your limbs or unfits you for ordinary labour?

5. Are you willing to serve as a native revenue officer for the term of ? years from ?

I, , make oath that the above questions have been separately put to me, that the answers thereto have been read over to me, and that they are the same that I gave and are true.

I also make oath that I will well and faithfully serve His Majesty, His Heirs and Successors, for the term of years as a native revenue officer.

Schedule contd.

(Signed) Candidate.

(Signed) Witness.

Sworn before me at Victoria, Hongkong, this day of , 19 .

(Signed) Magistrate.

I, , DECLARATION IN LIEU OF OATH.

solemnly, sincerely, and truly declare that the above questions have been separately put to me, that the answers thereto have been read over to me, and that they are the same that I gave and are true.

I also solemnly, sincerely, and truly declare that I will well and faithfully serve His Majesty, His Heirs and Successors, for the term of as a native revenue officer.

(Signed) Candidate.

(Signed) Witness.

Declared before me at Victoria, Hongkong, this day of , 19 .

(Signed) Magistrate.

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