1937_CROWN_REMEDIES_ORDINANCE__1875 — Page 3

146

No. 6 of 1875.

CROWN REMEDIES.

SCHEDULE.

FORM OF TREASURER'S CERTIFICATE.

Nature and particulars of claim for Crown rent.

2

3

Name of defendant.

Amount claimed.

No. of Crown lot in respect of which

rent is claimed. Term of lease.

Whether defendant is original lessee or assignee in possession by purchase or mortgage.

[s. 4.]

For what period rent is claimed and when due.

I, A.B., Colonial Treasurer of Hong Kong, hereby certify that the several persons whose names are entered in the first column of the above schedule have made default in the payment of the sums appearing opposite to their respective names in the second column, in respect of Crown rent, and I, C.D., Land Officer, hereby certify that the particulars of the above claims for Crown rent against such persons are truly set forth opposite their respective names in the 3rd, 4th, and 5th columns.

Dated the

day of

19

J

(Signed) (Signed)

Treasurer.

Land Officer.

Nature and particulars of claim for police, lighting, water and

Fire Brigade rates.

1

2

3

5

Name of defendant.

Amount claimed.

No. of tenementia respect of which rates are payable

Whether defendant is owner or occupier.

For what period rates are claimed and when due.

I, A.B., Colonial Treasurer of Hong Kong, hereby certify that the several persons whose names are entered in the first column of the above schedule have made default in the payment to the Crown of the sums appearing opposite to their respective names in the second column, and that the said persons are severally liable to the payment thereof in respect of the claims, the nature and particulars of which are truly set forth opposite their respective names in the 3rd, 4th, and 5th columns.

Dated the

day of

19

(Signed)

Treasurer.

і