At a special session of the justices of the peace of the county of [or riding, &c., as the case may be], acting for the division of [or otherwise, as the case may be] in the said county, holden at in the said on the day of in the year , We, , being justices acting for the said assembled at the said special session , do hereby authorize and empower A.B. of [here insert the name, description, and place of residence, and if more than one in partnership, say, C.D. of, &c, and E.F. of, &c. being partners] being a householder [or householders], [or keeper (or keepers) of a shop or stall, as the case may be], to buy game from any person authorized to sell game by virtue of an Act passed in the second year of the reign of King William the Fourth, intituled “An Act to amend the laws in England relative to game” ; and we do also authorize and empower the said A.B. [or C.D. and E.F. being partners] to sell at his [or their] house [shop or stall] any game so bought, provided that the said A.B. [or C.D. and E.F. being partners] shall affix to some part of the outside of the front of his [or their] house [shop or stall], and shall there keep, a board having thereon in clear and legible characters his christian name and surname, [or their christian names and surnames], together with the following words, “licence to deal in game.”

This licence will expire on

(Signed) Justice of the peace. Justice of the peace.]

F2The islands council of . . . (or, as the case may be) the . . . district council, do hereby authorize and empower A.B. of [here insert the name, description, and place of residence, and if more than one in partnership, say, C.D. of, &c, and E.F. of, &c. being partners] being a householder [or householders], [or keeper (or keepers) of a shop or stall, as the case may be], to buy game from any person authorized to sell game by virtue of an Act passed in the second year of the reign of King William the Fourth, intituled “An Act to amend the laws in England relative to game” ; and we do also authorize and empower the said A.B. [or C.D. and E.F. being partners] to sell at his [or their] house [shop or stall] any game so bought, provided that the said A.B. [or C.D. and E.F. being partners] shall affix to some part of the outside of the front of his [or their] house [shop or stall], and shall there keep, a board having thereon in clear and legible characters his christian name and surname, [or their christian names and surnames], together with the following words, “licence to deal in game.”

This licence will expire on

(Signed) F3. . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F4