.!
(Fourth Schedule.)
SCHEDULE
(Section 25)
186
Form of Declaration by Candidate as to Expenses.
I,
at the election of councillors for (the
the Municipality of Hong Kong on the
, having been a candidate
Ward of)
day of
19 do hereby solemnly and sincerely declare that I have paid
and no more for my expenses at the said
election and that, except as aforesaid, I have not, and to the best
of my knowledge and belief, no person, nor any club, society, guild,
or association, has on my behalf, made any payment, or given, promised,
or offered any reward, office, employment, or valuable consideration,
or incurred any liability an account of or in respect of the conduct
or management of the said election.
And I further solemnly and sincerely declare that, except as
aforesaid, no money, security, or equivalent for money, has to my
knowledge or belief been paid, advanced, given, or deposited by anyone
to or in the hands of myself, or any other person, for the purpose of
defraying any expenses incurred on my behalf on account of or in
respect of the conduct or management of the said election.
And I further solemnly and sincerely declare that I will not at
any future time make or be a party to the making or giving of any
payment, reward, office, employment, or valuable consideration for
the purpose of defraying any such expenses as last mentioned, or
provide or be a party to the providing of any money, security, or
equivalent for money for the purpose of defraying any such expenses.
day of
Signature of declarant
Signed and declared by the above-named declarant on the
before me
(Signed)
Justice of the Peace.