288 APPENDIX. 



and may cause the conviction to be drawn up in the following 

 form of words, or any form of words to the same effect ; (that 

 is to say,) 



" Be it remembered, that on [the time of conviction] at [place 

 " of conviction] [name of offender] was duly convicted be- 

 " fore me [name and style of convicting justice or justices, 

 " magistrate or magistrates], for that the said [name of 

 " offender] on [time of committing offence] did [here state 

 " the offence against the act according to the act], contrary 

 " to the form of the statute made in the year of the 



" reign of his Majesty King George IV., intituled [here set 

 "forth the title of this act], and I do hereby adjudge the said 

 " [name of the offender] to pay and forfeit for the said offence 

 " the sum of [fine] and also the sum of for costs, to 



" be distributed as by the said act is directed. Given under 

 " my hand and seal the day and year first above written." 



Appeal in 50. And be it further enacted, that it shall be lawful for 



any person or persons who shall think himself, herself, or 

 themselves aggrieved by the judgment of any justice or jus- 

 tices of the peace, or magistrate or magistrates, in England, or 

 by any act or judgment of the said commissioners and over- 

 seers, or other person or persons, done or given, or suffered 

 to be done or given in pursuance of this act, or by any rate 

 or assessment made in pursuance thereof, to appeal to the 

 justices of the peace of the county, division, or place where 

 such act shall have been done or such judgment shall have 

 been given, or where such rate or assessment shall be leviable, 

 at the next or next but one general quarter sessions of the 

 peace, but that no such appeal shall be received, heard, or 

 determined unless the appellant or appellants shall, within 

 four days next after such act or judgment shall have been 

 given, or such rate or assessment demanded, and fourteen 

 days at least before the holding of such sessions, give or 

 leave notice in writing, in case of conviction, as well at the 

 public office of the clerk of the peace for such county, di- 

 vision, or place where such person or persons shall be con- 



