E9
B.
G. Have you parted with any real or personal property during the past twelve months? If so, give particulars,
G. 6)
B. **Chibur DOMIGA labilities" include much
bihle
money! Swing
kapena say
docent or
10 de 107
KKKİNEL
C. 10 Im
proves explem)
value to b
med.
ઈન vida b beatured, c... where subjec
16 MONTERIE
Or whene aprikuro b
derent du Besa
tham Breebold,
Where
plicant i pari OFICI Cody.
wate whelber
the mone
or charge i over the whole
de QNİT OPER
the applleman's
bars of Latecal
D. State
whether single,
marded, wİOW
or widowes. Divores. married but UVER MAN, under deprec er order of
Cours or under
& died of
separation, DHE much other abrticular
may be appro
B. State seperately th
COMALC
of the Ipcome of the appl cod of
18
B. Give particulara of any mortgages, bill of sale or other charges existing in connexion with the property referred to in paragraph A above, and any other financial Habilities to which you are subject.
C (0) Do you owe the dwelling-house used by you as your home?
C. ()
DNJA GAMA JANG
II 10-
What is the value of such dwelling- house?
What is the value of your interest in such dwelling-house”?
Give particulars of mortgages, charges and other interests affecting such dwelling. house.
D. ( What is your marital status?
D. Q
(Ü) la any person totally dependent on you? Give full particulars, including ages of children,
()
E. What was the amount of your income and (if married) the income of your spouse from all sources during the period of twelve mooths preceding the making of the within application?
E.
If so.
(i) Have you ever been bankrupt or assigned your estate in any way? give particulars.
And I make this solemn declaration conscientiously believing the same to be true and by virtue of the provisions of the Statutory Declarations Act 1835.
Declared
Signature.
at Hoog
Kong
this
19
meur day of
Before me.
Commissioner for Oaths,
Alternative Form of Declaration.
G. See mo
to parapetpl
A Above A
do "proper"".
DENGAN MON TOA+++ KEMAMAN KEN
to be used by person who does not understand the English language.
Declared at Hong Kong the through the interpretation of (0
G) Nanse of buerpreter full
(6) Adderal
***** 19
having also first declared that he had truly, distinctly and audibly interpreted the contents of this document to the declarant, and that he would truly and faithfully interpret the declaration about imerpreter. to be administered to him.
day of
of t
the said
F. State a
F.
Boneca of lacome, sp
bury or
From what sources was such in- come derived ?
F. ()
LONDON GAAN JA
Jeg lurers
of proporlex
on TOPTANIES, EDGA
Lacome them.
conduct of
fan or bon 1-
from vakog in
boarders or
(enslar (oort;
pecudoca
$19%, 62.
(i) If derived from employment, set out the names and addresses of the various em- ployers during the period referred to above.
()
by ETOPROLDEN
Before me,
Commissioner før Oaths.