the Commissioners of Assessed Taxes acting within and for the said District, the foregoing Charges of the Duties of Assessed Taxes for the Year ending the Fifth Day of April 18 made by me upon the several Persons before mentioned, pursuant to the Statutes in that Behalf.

Witness my Hand, this

in the Year of our Lord 18

Day of

No 45.

Form of Oath of Service of Notices of Charge to be subjoined to the foregoing Certificate, Form No 44.

I

of

do swear, That a Notice in Writing was duly served upon each Person mentioned in the above Certificate, containing the Particulars as set forth therein respectively, on the Day or Days mentioned in the said Certificate.

Sworn at
the

in the County of

Day of

Form of Allowance by the Commissioners of Surveyor's Certificate of Charges, Form No 44.

THE foregoing Certificate of Charges of the Duties of Assessed Taxes having been presented to us the undersigned, Commissioners of Assessed Taxes acting in and for the District of

in the County of and Oath having been made that a Notice of Charge has been duly served upon each Person mentioned in the said Certificate as the Party charged, pursuant to the Statute in that Behalf, we the said Commissioners do hereby allow the said Certificate.

Witness our Hands, the

in the Year of our Lord 18

Day of

No 47.

Form of Surveyor's Certificate of Charges of the Duties on Profits arising from Property, Professions, Trades, and Offices, for Supplementary Assessment.

A CERTIFICATE of Charges of the Duties on Profits arising from Property, Professions, Trades, and Offices for the Year ending the Fifth Day of April 18 made pursuant to the Statutes in that Behalf by Surveyor of Taxes acting for the District in the County of and presented to the Commissioners of the Property and Income Tax acting in and

of

for

for the said District [or the Commissioners for Offices for the Department of

I

in the County of

[Here set forth, in such tabular or other Form as may be convenient for the Purpose, the Names of the several Parties charged, and of the Parishes or Places in which they ought to be assessed, with the Particulars, and the Amount of the Charges, and Dates of the Service of Notices of Charge.] Surveyor of Taxes acting for the District of do hereby certify to the Commissioners of the Property and Income Tax acting within and for the said District [or the Commissioners for Offices for the Department of the foregoing Charges of the Duties payable under the Act 5 and 6 Vict. c. 35. for the Year ending the Fifth Day of April 18 made by me upon the seve ral Persons before mentioned, pursuant to the Statutes in that Behalf.

Witness my Hand, this

Year of our Lord 184

,

Form of Oath of Service of Notices of Charge to be subjoined to the foregoing Certificate, Form No 47.

I

of

do swear, That a Notice in Writing was duly served upon each Person mentioned in the above Certificate, containing the Particulars as set forth therein respectively on the Day or Days mentioned in the said Certificate.

Sworn at
the

Day of

in the County of

18 before me

Commissioner of the Property and Income Tax [or Commissioner for Offices].

No 49.

Form of Allowance by the Commissioners of Surveyor's Certificate of Charges, Form No 47.

],

THE foregoing Certificate of Charges of the Duties payable under the Act 5 and 6 Vict. c. 35., having been presented to us the undersigned, Commissioners of the Property and Income Tax acting in and for the District of in the County of [or the Commissioners for Offices for the Department of and Oath having been made that a Notice of Charge has been duly served upon each Person mentioned in the said Certificate as the Party charged, pursuant to the Statute in that Behalf, we the said Commissioners do hereby allow the said Certificate.

Witness our Hands, the

Year of our Lord 18

Day of

in the

Commissioners of the Property and Income Tax [or Commissioners for Offices].

No 50.

Form of Certificate under the Act 43 Geo. 3. c. 99. s. 35. as to
Duties of Assessed Taxes in arrear.

To the Commissioners of Assessed Taxes acting within and
for the Parish of
in the District of

in the County of

WE the undersigned, Commissioners of Assessed Taxes acting within and for the Parish of in the District of in the County of , do hereby certify, That in and. by the First [or Additional First, or Supplementary, as the Case may be,] Assessments of the Duties of Assessed Taxes for the said last-mentioned Parish for the Year ending the Fifth Day of April 18 A.B., now residing in the Parish of aforesaid, hath been duly charged and assessed in the Sum of for the under-mentioned Duties of Assessed Taxes;

And we do further certify, That the said A.B. hath left unpaid the Sum of in respect of the said Duties so charged and assessed as aforesaid, which became due and payable on the Day of and the said last

mentioned Sum is now in arrear.

And we the undersigned Commissioners do request you the said Commissioners of Assessed Taxes acting within and for the Parish of aforesaid to raise and levy the said Sum of so charged and assessed upon and left unpaid by the said A.B., and now in arrear as aforesaid, and to cause the same to be paid and applied according to the Directions of the several Acts of Parliament for raising the said Duties.

Given under our Hands and Seals at

Day of

in the said

Form of Warrant to be annexed or subjoined to the foregoing

Το

Certificate, Form No 50.

and

of Assessed Taxes for the Parish of

Collectors of the Duties

in the

District of

in the County of

within and for the Parish of

in the District of

WE the undersigned, Commissioners of Assessed Taxes acting

in the County of
do hereby authorize and require
you, the above-named Collectors, or either of you, to make due
Demand of and from A.B., the Person named in the foregoing Cer-
tificate, of Payment of the Sum of
in respect of the
Duties of Assessed Taxes charged and assessed upon and left un-
paid by him, as in the said Certificate is mentioned, and if he shall
refuse or neglect to pay the same upon such Demand being made,
then we hereby empower and require you or either of you to dis-
train for the same, according to the Directions of the Statute in
that Behalf, by virtue of this our Warrant, without further Au-
thority; and upon Receipt of the said Sum of Money or any Part
thereof we hereby direct and enjoin you to pay over the same to
the Receiving Officer for the County of
to the Account

of the Collectors of Assessed Taxes for the said Parish of
for which this shall be your sufficient Authority.
Given under our Hands and Seals at
District of

this

in the Year of our Lord 18

in the said

Day of

Form of Certificate under the Act 5 and 6 Vict. c. 35. s. 177., as to Duties in arrear.

To the Commissioners of the Property and Income Tax
acting within and for the District of
County of

in the

in

WE the undersigned, Commissioners of the Property and Income Tax acting within and for the District of the County of do hereby certify, That in and by the First [or Additional First, or Supplementary, as the Case may be,] Assessments of the Duties payable under the Schedule [or respective Schedules] of the Act 5 and 6 Vict. c. 35., in the said District of

for the Parish of

for

the Year ending the Fifth Day of April 18, A.B., now residing

in the hath been duly charged and assessed for the

under-mentioned Duties; (that is to say,)

[Here specify the Particulars of the Assessment.]

Total

£

£

S. d.

And we do further certify, That the said A.B. hath left unpaid the Sum of in respect of the said Duties so charged and assessed as aforesaid, which became due and payable on the Day

Day of

[or, as the Case may be, that the said A.B. did not, at the Time of his being so charged and assessed as aforesaid, reside, nor does he now reside, in the said Parish of

and that the Sum of

in respect of the said Duties so charged and assessed as aforesaid became due and payable on the ], and the said last-mentioned

Day of

Sum is now in arrear.

And we the undersigned Commissioners do request you the said Commissioners of the Property and Income Tax acting within and for the District of aforesaid to raise and levy so charged and assessed upon the

the said Sum of

said A.B., and now in arrear as aforesaid, and to cause the same to be paid and applied according to the Directions of the several Acts of Parliament for raising the said Duties.

Given under our Hands and Seals at

within the

Day of

Commissioners of the Property and Income Tax.

No 53.

Form of Warrant to be annexed or subjoined to the foregoing Certificate, Form No 52.

Το

and

Collectors of the Duties on Profits arising from Property, Professions, Trades, and Offices for the Parish of in the District

in the County of

of WE the undersigned, Commissioners of the Property and Income Tax acting within and for the District of

afore

said, do hereby authorize and require you the above-named Collectors, or either of you, to make due Demand of and from A.B., the Person named in the foregoing Certificate, of Payment of the Sum of in respect of the Duties charged and assessed upon him, as in the said Certificate is mentioned; and if he shall refuse or neglect to pay the same upon such Demand being made, then we hereby empower and require you or either of you to distrain for the same, according to the Directions of the Statute in that Behalf, by virtue of this our Warrant, without further Authority; and upon Receipt of the said Sum of Money or any Part thereof we hereby direct and enjoin you to pay over the same to the Receiving Officer for the County of Account of the Collectors of the said Duties for the Parish of for which this shall be your sufficient Authority.

Given under our Hands and Seals at

said District of
of

this

in the Year of our Lord 18

Commissioners of the

to the

in the Day

{Property and Income Tax.

N° 54.