SYSTEMS OF LAND VALUATION IN THE UNITED KINGDOM 



103 



I hereby declare that the foregoing particulars are in every respect fully and truly stated 

 to the best of my judgment and belief. 



Dated this 



day of 



191 



Signature of person 

 making the Return. 



Rank, Title, or 

 Description. 



II. Additional particu'ars which may be given, if desired. 



Signature 



FOP.M 4. 



Date 



