other · 1901
A declaration form for official purposes, likely related to licensing, requiring the licensee to provide accurate address details and make a solemn declaration.
April 12, 1901. of I, of hereby declare that the statements made and the answers given by me in reply to the questions …
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Recorded in this notice
Victoria Government Gazette, No. 44, 1901.
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Near this placeState of Victoria · Bailiwick of the State of Victoria