* FORM LA.
Requisition for particulars as to tenements,
KATING ORDINANCE-ANNUAL VALUATION FOR THE YEAR (1)
In pursuance of section 4 of the Rating Ordinance, Chapter 116, I require you to furnish me with the particulare relating to the undermentioned TENEMENT, and return the same to me at the RATING AND VALUATION DEPART MENT (2) from the date hereof.
within TEN DAYS
(3)
2
General de scription of TENEMENT, CA BEL dwelling house. shop, factors. podesen, clinke club, etc.
2
If any part of the TENEMENT in Tet by you, sate the part occupied by, and thự mázsló) ei, the tezamki, Sare the rent paid by each senang, whether in includes tubes, and the amount of contruction fee df any) peorived by you, vogeÉÍST with the daje of receipt. Stave it aner part of the TENE- MENT 18 occupied by the owner, or is occupied
Pard(s) bezu med by the tengolfs), of by the dinti, of anocomuled
3
If the TENEMENT 1, te lo
you, mhic the ren, whether it
(6)
4
5
6
If the rest
indudes rates, And the com druction leg or premimin di EF the whole ngj anx) paid by YOU
stated in Cak.
2 à 3 includes services, such as
together any pan of the state whether rumules of tits,
With tho daÊ DE Vżyment
Conurustion
Constructide
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roczived
Does
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jay
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Ice received
by JOQ
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prid by nou include
by you
FUM? | AuQnati
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Date
pald
ma? Amount) Bale
$ froccher
pumzises is
jet ou tease,
dizze the
kogth of the periodte) and the commENC= ing date(s)
OVICI DI
Têrché pis for keeping the premises
la sepult
die sonditioning, lets, provided by The landlord, Rate the more of these servİDER, and the coti-
pense of providlar samt
(3)
(4)
(7)
·
$
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F
(B)
(9)
(10)
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(1) Financial pour for Which Valuation B to be DiCOUNT.
(2) Corren adman of the Rating & Valandan Department,
(3) Name and address al Owner of Occupier, or Aptos for Owner or Òecopier, of BE RECANI MENİübed above.
(4) Description of societal to be rated.
(5) Dal of despatch of the Form IA.
نیا
(8) Addres of the person completing the For 14, belor the Owner or Decopier, or Agent for Owner or Occupier, of the incment meastlosed above.
$) Date of return of the Form 14 by the pettóŋ di spitting L
110) Sionature of the pepido côtipleting the Farm 1A, being the Owner or Occupier, at Agtal for Owaer or Occupiët, of the tentment mentioned above, “i' and
(0) Name and title of Head of Depiętszett,
NOAL