FSE

10 1jjal no yoiwoes benoijnem svode ant

Beijoйtus

+

.beruter ed føde sejnerava

- ad dom scsoltitiso bian vid bisode 1everoH

lo stab ent. Mori aysb ytenin to vilqze said sroled bensa

bojaɔalinoɔ að IIera valiwasa erit,1000,add to Joyxe

mi penoidne jus vrij galweddo to aslðltoftus are yd

„bløy ed Ilaria vajnaiuug. Io 19dJvi and

FORM A.

328

Form for Deposit of Security on Export Coal.

Description of Coal

Place of Origin and quali-

ty.

Weight in Tons.

Value

Nationality of Steamer

on which loaded.

Port of Export

Destination

Consignees

Purpose

In Yen

Name: nationality: sall

or steam.

Name of port.

Use to which coal is to be

put: e.g. bunkers, fac-

tory use etc.

It is hereby declared that the above coal, upon

permission to export being granted, will be exported

to the above destination,

yen

Consequently the sum of

Should the above de-

being double the value of the said coal is

herewith deposited as security.

claration be violated (with the exception of sinking,

loss by fire, stranding, beaching, collision or other.

act of God, or force majeure, or when taking the pro-

per course the vessel be attacked, taken, detained or

stopped

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