other · 1871
A form for claiming drawback on goods subject to ad valorem duty, detailing claimant, exporter, consignee, and payment.
Her Majesty's Government, Dr. to (Signature of Claimant.) To drawback of duty upon the goods specified in Export …
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Recorded in this notice
RoleClaimant
RoleExporter
RoleConsignee
OfficialLanding Surveyor
OfficialCollector of Customs
Rolemaster
LocationCustom House
LocationCustom House
NSW Government Gazette, No. 85, 29 December 1871.