Special Notice in Writing
Province of Québec,
Municipality of ..............
To
J. B.
(Style,)
Sir,
Special notice is hereby given you by the undersigned, L. M., (name and style of the undersigned) that (the object of the special notice.)
Given this .............. day of the month of .............. 19..............
L. M. or
(style,)
his
L. X M.
mark, affixed in
presence of N. O.
Witness.