Tons.

(") Additional Particulars for Steamers. Deduction for Space required for Propelling Power (say whether orths or oths, or as

measured)

[No. 49. Price 2d.]

No. of Horses-power.

Combined Power (estimated Horse-power)

Register Tonnage, (after making Deduction for

Space for Propelling Power in Steamers) (a))
I, the undersigned A.B., Registrar of the Port of

, hereby certify, that,
(1.) The Ship, the Description of which is prefixed to this my Certificate, has been duly surveyed, and that the above Description
is true.
(2.) C.D. of

is the Master of the said Ship.
(3.) The said Ship
was built at
[naming the Country and Place] on
the

was condemned by the Court of
and her Foreign Name is

[naming Court on the
[these words to be added if the Ship

Day of

at
is Foreign.]

(4.) The several Persons and Bodies Corporate whose Names are hereunder written [or endorsed] are Owners of the above Ship, in
the Proportions set opposite their respective Names.

(Signed)

_Registrar.

Day of

or {Place where she was built is not known, and}

or

Dated at

(Signed)

Registrar.
the
Day of

18
Notice.-A Certificate of Registry granted under The Merchant Shipping Act, 1854, is not a Document of Title. It does not
necessarily contain Notice of all Changes of Owuership, and in no Case does it contain an Official Record of any Mortgages affecting
the Ship.

Tonnage.

No. of Tons.

In witness whereof I have hereunto subscribed my Name and affixed my Seal, this

Tons.

() Additional Particulars for Steamers, Deduction for Space required for Propelling Power (say whether orths or noths, or as measured)

Feet.

Tenths.

Length of Engine Room (it measured).

Combined Power (estimated Horse-power)

Register Tonnage, (after making Deduction for

Space for Propelling Power in Steamers) () }

Foreign}

or

in the County of

declare as follows:
(1.) I am a natural-born Subject of Her Majesty, born at (naming Place of Birth],

and have since I took the Oath of Allegiance to a Foreign
and have never taken the Oath of Allegiance to any Foreign

State (naming State) and on the

Day of

taken the Oath of Allegiance to Her Majesty, and am resiState.

dent at

(naming Place] being a Place within
Her Majesty's Dominions.

or
naturalized by Act of Parliament

naturalized by an Ordinance of the proper
a Denizen by Letters of Denization)

of the United Kingdom [cite the

legislative Authority of dated the

or [naming British Possession] [cite the Year
Day of

Year in which the Act was passed,
Lits Chapter and Title.]

in which the Ordinance was passed its Chapter

and Title.]
and am resident at [naming Place], being a Place within Her Majesty's Dominions.

And I have
since I so became a Denizen,} or since the passing of the said Act or Ordinance,
and on the
Day of

taken the Oath of Allegiance to Her Majesty.
(2.) To the best of my Knowledge and Belief, no Person or Body of Persons, other than such Persons or Bodies of Persons as
are by The Merchant shipping Act, 1854, qualified to be Owners of British Ships, is entitled as Owner to any Interest whatever,
either legal or beneficial, in the said Ship.
And I make this solemn Declaration conscientiously believing the same to be true.

(Sigued)
Dated at
the
Day of

18 Made and subscribed by the above-named A.B. in the Presence of me

S Name of Registrar or Justice of the Peace (Signed)

acting in and for