Certificate given under Special Oath
Province of Québec,
Municipality of ..............
I, the undersigned, N. C., (style,) residing in .............. being duly sworn, do depose and say that I have published the public notice hereunto annexed (or the within public notice,) by posting a copy thereof at each of the following places, viz: (places where the notice was posted.)
In testimony whereof, I give this certificate, this .............. day of the month of .............. nineteen hundred ..............
N. C., or
(style.)
his
N. X C.
mark, affixed in
presence of N. O.,
Witness.
Sworn this .............. day of the month of .............. 19.............. at (place) before me, the undersigned, A. B., justice of the peace, (or warden, etc.)
A. B.
(Style.)