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C-27.1 - Municipal Code of Québec

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FORM 16
(Repealed).
M.C. 1916, Form 14; 1996, c. 2, s. 454.
16
(Article 420)

Certificate under special Oath

Province of Québec,
Municipality of ..............

I, the undersigned, P. T., (style) residing in (residence) being duly sworn, do depose and say: that I served the within special notice in writing (or the special notice in writing hereunto annexed) upon (as set forth in Form 4.)

In testimony whereof, I give this certificate, this .............. day of the month of .............. nineteen hundred ..............

P. T., or
(style,)

his
P. X T.
mark, affixed in
presence of N. O.,
Witness.

Sworn this .............. day of .............. 19.............., at (place) before me, the undersigned .............. Justice of the Peace (or Warden, etc.)

H. P.,
(Style)
M.C. 1916, Form 14.
© Gouvernement du Québec