Page:Life Annuities Act 1808 (ukpga1808142).pdf/15

Rh SCHEDULES to which this Act refers

SCHEDULE (A.)

A.B of  do herbey decalre to the Commissioners for the Reduction of the National Debt; That I am desirous on my own Account, [or, on Behalf of C.D.   of   ] to transfer to the said Comississoners the sum of    £3. per centum Consolidated [or reduced] Bank Annuities. for the Purchase of  a Life Annuity: And I do hereby nominate myself [or, C.D.   of   ] now of the Age of   Years, to be the Person on the continuance of whose Life [or, in case of Two Nominees, myself, now of the Age of   Years and E.F   of   now of the age of   Years [or E.F. of   now of the Age of v Years, and G.H. v of   now of the Age of   Years] to be the Persons on the Continuance of whose Lives and the Life of the longer liver of them] the said Annuity is to depend, and whose Age [or, respective Ages, as the case may be] is [or, are] certified and verified by the Certificates and Affidavits [or' Affidavits] now [or', which have been before] produced.

Witness my Hand, this  Day of   SCHEDULE