General Cattle Mutual Insurance Fund. 



469 



Form op Certificate enclosing Claim. 



I hereby certify that the following head of cattle, insured in the Mutual 

 Insurance Fund through the Postmaster-General, died of disease at the dates 

 annexed. 



The above is a true statement, 

 (^Address.) 



John Jones, Owner, 



I have seen the dead bodies of the above cattle, which, I believe, are insured 

 by the Postmaster- General, and died of disease by natural causes. 



Edward Evans, 

 (an Insurant of Cattle in the Mutual Insurance Fund). 



(^Address.') 



Similar certificate to be signed by the other witness, whose 

 certificate is required. 



Form A. ( Where Insurance is on office value.) 



Cattle in the Sheds and on Farms in the occupation of , 



in the Parish of 



Description. 



Cow (Shorthorn), white 

 Ox (Hereford), red .. 

 Cow (Devon), red 

 Ditto 



Age. 



Value 

 estimated 

 by Owner. 



Years. 

 2 

 4 

 6 

 3 



18 

 30 

 15 

 13 



Insured 

 Value. 



£. 

 12 

 21 

 10 

 9 



Note. — The office value would be taken at the lowest estimated value of the 

 beast in health during the term of insurance. Thus, if a cow when first in milk 

 is worth 221., and out of milk 18/., the latter sum will be the office value, which 

 would be the limit of insurable value. 



Policy to run in this sort of form : — 



No. . Date, August (October) 1, 1S66. Term of policy one year; 

 expires August (October) 1, 1867. 



The Postmaster-General has received from John Jones, of the parish of 

 Bradley, the premiums for each head of the annexed list of cattle. 



And he hereby undertakes to pay the said owner the insured value on 



