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240
I, MACKERTICH CYRIL OWEN, of Viotonia in the Colony
of Hongkong, Merchant, do scleraly, sincerely and truly
deolare and say as followe:-
1. On the 18th day of levember 1917 I signed the
Kenc¬ial and humble netition for a Certificate of Imperial
Naturalization which is heretc annexed.
2. The statements ocntained therein are true ir
every particula”.
And lastly I make this solemn Deoleration
ocnsoientiously believing the same to be true and by
virtue of the Provisions of the Statutory Coolamations
Aot 1835.
DECLARED at Victoriz aforesaid
this sixteenth day of November
1917.
(sd.) K. C. Cren.
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mava [[tw maqoldi tad muar hYA
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‚olidvi prated & mosto±102
Before me,
(sd.) Chae.
F.
Wilkinson,
Notary Publio,
Bengkong.