FO371-23514 — Page 262

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(8810/603) W124754/5553/36599 100 9/38 FHD Gp683

This space for Official use only.

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Application Form A

Number and description of Enclosure forwarded with this application.

98

APPLICATION FOR EXPORT LICENCE.

Attention is drawn to the Instructions appearing on the back of this form. Delay may be caused if these instructions are not followed, if any of the questions below are not answered, or if the declaration is not signed. (See Instruction 8.) It is requested that the form be filled in legibly, preferably typewritten.

This column is for Official use only.

Licence

Checked by..

Applicant's Reference No... 273

(See Instruction 3.) Date.

(a) Full name and address of CONSIGNOR

(See Instruction 8.)

2.6.39.

Imperial Chemical Industries Ltd.

Imperial Chemical House,

Millbank, S.W.1.

(b) If a registered dealer under the Firearms Act, 1937, give date and number of current certificate; and name of issuing authority.

(c) Name and address of person or company to

whom the licence is to be sent.

(d) [1] Proposed date of despatch of goods.

[2] If the goods are to be despatched by Parcel Post state Post Office of despatch. (See Instruction 6.)

(e) Prospective port, and country in which situated,

to which the goods are to be exported.

(f) FULL NAME and POSTAL ADDRESS of

CONSIGNEE ABROAD.

As above.

Shipping Departmen

[I]

16th June, 1939.

[2] By Parcel Post from

Post Office.

Rangoon, Burma for China.

The Representatives of the Kwangsi

Provincial Government,

Rangoon.

The Instructions in paragraph 4 on the back of this form should be carefully observed when completing this table.

(g)

Quantity

(See Instruction

No. 4[d]).

Full Description of the Goods (including calibre, &c.)

110,200 lbs. T.N.T. for Sheil and Mine fiiling

Total F.0.B. Valne,

If more than one commodity, state values separately.

£

£4750

Total

Total

I hereby declare that to the best of my knowledge and belief all the particulars in this application are correctly stated, and I undertake that if this licence is granted to me, it shall be used solely for the export of goods being my own property or the property of u person, firm or company for whom I am authorised to uct in this transaction as the sole responsible representative. I am aware that any licence granted to me is issued on the condition that the Owner or Shipper of the exported goods, if so required by the Commissioners of His Majesty's Customs and Excise, shall produce to them, within such time as they may allow, proof to their satisfaction that the said goods were duly delivered to the consignee at thé destination named in the licence. I undertake if this licence is granted to me to comply with this condition.

IPARIAL CHEMICAL INDUSTRIES LTD.

SIGNED

“AUS. EVɑns

N.B.-This Form must be signed in accordance with fia. Shipping Dept.

If the signatory has been specially approved to sign applications on behalf of his firm, quote here

(fficial No.

of the letter approving him for the purpose.

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