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Towns Improvement Clauses Act 1847

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Section 172

SCHEDULE (A)U.K.Form of Rate

An assessment to the sewer rate [or other rate,&c., as the case may be] for the [name the district or town], made this day of in the year of our Lord 18 , after the rate of pence in the pound, by virtue of the [name special Act].

No. on the rate.Name of person rated.Name of the owner of property rated.Description and situation of property.Gross annual value.Full net annual value.Rate atd. in the pound.Amount of drainage rate (if any).

Signed by us this day of in the year of our Lord

A.F.M

C.D.

E.F. _________________Improvement

G.F. Commissioners

L.K.

L.M.

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