Fourth Schedule., The Freetown Municipality Ordinance

Form 1. (First Schedule, Part I, paragraph 1.) VALUATION LIST. I No. of house or Descrip· Annual Kame of plot of tion of Name of Name of rateable Remarks land in premises owner occupier value Street street I ----- I I I I Form 2. (First Schedule, Part I, paragraph 2.) DECLARATION AS TO YEARLY RENT OF PREMISES. Name ............................................................................. . I, .................................... of .................................... do Premises ....................................................................... . Rented from ........................................................... . or let to ....................................................................... . Rent per annum ..................................................... . Date......................................... .l9 ............ . hereby declare that the rent paya?le by/to me iJ?- respect of the premises No ................... m .................................... Street, Freetown ............................................... . rented/let by me ....................... .from ........... . mefto ........................................ ..is at the rate of ................................................ per annum. Declared .......................................... 19 ............ . Before me. Valuer. Signature or mark of Declarant. Form 3. [SECTION 91] RATE. An Assessment for the City Rate of the City of Freetown, made by the City Council of Freetown this ......................................... . day of.......................................... , 19 ............ , at the rate of.................................... pence in the Pound. I I I I Arrears Due or Name of Name of I Description of Property Name or Situation ; Estimated Annual Rate at d. in if Excused Occupier Owner Rated of Property Extent Value the Pound £ 8. d. £ 8. d. £ 8. d. 1 ... 2 ... 3 ... 4 ... l I ~~f~~/~~{~~ft:::::::::::::::-:-:-·-·. ?6If:>. n ..§. en c.n..__.