Appy Gov. 57.29 041/66 av
Copy Certificate duas inf 20 mai 167-1772/6
Ansee? 14 May 187 - 4360
9698
1092 Hendong
67 Serieyton Grace Act 25th 166
RECEIVED
OCT 26 1866
203
I have the hour to transmit
In accordance with the instruction,
the Lt. Steuble the Rector of
Iata, as duly attested Certificate of this date of my
birth, will be sufficient evidence
as to the ground
which I have
claimed a retiring pension
or I. Rogus Bart.
I have the hour to be
Ir
Your Most obedient Servant-
A. J. Imm
Chaplain of Roughing