Sessional_Paper_1938 — Page 148

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Appendix 1.

GOVERNMENT OF HONG KONG

In consideration of the Hong Kong Government providing me the undersigned

Here insert full name of person signing under- taking.

Here insert full name of each person in charge of or accompany- ing the person signing.

and

Witness to above signature.

with board and lodging at the Jockey Club Stands at Happy Valley, I hereby agree to pay to the said Government on demand in respect of such board and lodging the sum of Five dollars ($5.00) per day for each adult and three dollars ($3.00) for each child under 15 years of

age.

Signature

Last address in

SHANGHAI

Occupation

If signed by married woman

full name and occupation?. of husband

This form must be signed by every person who accepts board and lodging under the arrangements made by the Government of Hong Kong.

Those who do not have funds immediately available will thus be able to obtain credit.

Those who are unable to afford these charges will be required to appear before a Government representative and to give a full statement of their circumstances.

W. J. CARRIE, Chairman,

Shanghai Refugees Committee.