45875-1916-Order-under-the-Importation-and-Exportation-Ordinance-1915 — Page 33

THE HONGKONG GOVERNMENT GAZETTE, JANUARY 7, 1916,

FORM NO. 8.

EXPORT STATEMENT.

[Rule 27.]

(Importation and Exportation Ordinance, 1915.)

I (we) hereby declare that the following articles were exported

by the S.S..

...which left the Colony

for..

No. of cases or other articles.

on.

Cargo.

Description of cases or other articles.

Weight Marks. No. or Quan-

tity

Con- Con- Con- tents. signor. signce. destination

Port of

Ship's Stores.

No. of cases or other articles.

Description of cases or other articles.

Contents.

This statement is also furnished as the export manifest under the Declarations of Ultimate Destination Ordinance, 1915.

Dated the................................day of...........

.191......

Owners, Agents or Charterers.

(Address.)

(Additional personal signature if the above name be that of a body corporate or firm or association or organisation.)

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