613996-1930-Supplementary-Bill-read-a-first-time--Motor-Spirit — Page 27

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Ships stores.

Schedule

Form No. 11

contd.]

No. of

Description

cases, etc. of cases, etc.

Nature of light oils.

Quantity in gallons.

Total value.

Date.....

(Owners, charterers, agents or master.)

(Address.)

(Signature of employé or agent if the above signature is that of a body cor- porate or firm.)

FORM No. 12.--EXPORT STATEMENT.

[s. 27.]

Motor Spirit Ordinaner, 1930.

1 (We) hereby declare that the following light oils

were exported by the S.S.

which left the Colony on the

Date..

Cargo.

No. of Description

cases,

etc.

of cases, ete.

Marks. Nos.

Nature of Fight oils.

in gallons.

Quantity Total value.

Description

No. of cases, etc. of cases, etc.

Date.....

Ships stores.

Nature of light oils.

Quantity in Total value.

gallons.

(Owners, charterers, agents or master.)

(Address.)

(Signature of employé or agent if the above signature is that of a body cor- porate or firm.)

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