TOBACCO.
No. 10 of 1916.
2453
Ships stores.
[Second Schedule contd.]
No. of cases. Description of cases. Nature of tobacco. Weight in lbs. Total value. Date......
(Owners, charterers, agents or master.) (Address.)
(Signature of employé or agent if the above signature is that of a body corporate or firm.)
FORM No. 11.-EXPORT STATEMENT.
[s. 29.] Tobacco Ordinance, 1916.
I (We) hereby declare that the following tobacco was exported by the S.S..
the........ Date...... which left the Colony on
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