Advertisements. 



Schedule B. 



Declaration Jor use in case of movement of swine into a sivine fever-infected area. 

 Stock Diseases Act 1S90. 



Declaration of owner (or his agent) — 



I, ,of 



parish of , county 



sincerely and solemnly declare 



, in the 

 , do hereby 



{a) That I am the owner (or agent for the owner) of tlie under- 

 mentioned swine, which have been in my (or his) possession 

 for twenty-eight days ; 



(b) That the place of destination is 



{c) That they are free from disease, and now at 



from whence they are to be moved to the premises of 

 at , which are 



within an infected area ; 



{d) That the swine are not at the date hereof in a place 

 infected with swine fever ; 



(e) That to the best of my knowledge and belief the swine are 



not affected with swine fever, and have not been in 



any way exposed to the infection of swine fever ; and 



(/) That the movement of the swine is not prohibited. 



Number and Description of 

 Swine to be moved. 



Name or Description of Place 



and Premises from which 



Swine are to be moved, and 



District in which situated. 



Place of Destination, stating 



Name or Description of Place and 



Premises to which Swine are to 



be moved, and authority for 



such movement. 



And I make this declaration conscientiously believing the same to 



be true, and by virtue of the provisions of an Act of Parliament of 



Victoria rendering persons making a false declaration punishable for 

 wilful and corrupt perjury. 



T3eclared before me, at in the State 



aforesaid, this day of in 

 the year of our Lord One tliousand nine hundred and 



Justice of the Peace, or 

 Commissioner for taking Declarations and Affidavits. 



