1965-HKRS30-8-56_Part04 — Page 26

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.