SCHEDULE.
BEING THE FORM OF JUDGMENT OR CONVICTION
BY THIS ORDINANCE REFERRED TO
HONGKONG
Be it remembered, that on this
184
day of
(name) of (place) was duly convicted before me A. B. (or us A. B. & C. D.) one (or two, or more, as the case may be) of Her Majesty's Justices of the Peace, upon an information in that behalf exhibited before (name of the Justice or Justices) on the
day of
now last past, for that on the
day of
194
(state the fact or offence in respect of which the Judgment or Conviction is had) and I (or we) do (if the conviction is made for an offence against any particular Statute or Ordinance, state it) award, order, and adjudge, that (set forth the adjudication, and if awarding a penalty, as follows) the said (offender) do for such offence (where necessary add being his second, or third, or subsequent offence, as the case may be) forfeit and pay the sum of
to be distributed as in manner following; "that is
to say," (describe the mode of distribution,) (or if a Chinese offender describe the substituted punishment) besides the costs and charges of, and attending this conviction (if given) which said costs and charges, I (or we) the said Justice (or Justices,) do hereby ascertain and assess, at the sum of
Given under my hand and seal
(or our hands and seals) the
day and year first above
written.
HONGKONG, Published by Authority.
Printed by John Cairns.
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