JB/124/059/002

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6 +
Forms VI
Requiem No 3 continued

To the Governor of the National General Panopticon
Penitentiary-House

Sir [Town County this day of Month Year]

Being satisfied by inspection and examination
that of the person as by the report
of diverse credible persons as compared with
the description in my custody [or by my own personal knowledge] [or by the otherreport
of divers persons credible persons sufficient testimony] + + Instruction to the Post Master in relation to his A.P. certificate as above
N.B. To save the Annuitant when already known as such the trouble
of personal appearance attendance or in comparison
to an Annuitant who through infirmity
or otherwise is unable personally to appear attend, the Post Master
may sign remitt a Letter of request upon the report of as stand in the
above form remitt the Petition in question upon the report of others: a Letter of
and Request that the
signature above contained is the signature of
the a person known by the name therein
contained and that the said person is as he
Requiem avers upon the list of Requiem Superannuation Annuitants [+] [+] belonging to the
General Panopticon
Penitentiary House I hereby transmitt his said Letter Petition to you
accordingly, together with this my certificate: requesting
you to remitt to me the amount of the
payment or payments due upon the said
Annuity as therein mentioned; which, as soon
as received, or so much thereof as shall have
been received by me, I hereby engage to pay either at once
by in the lump or [+] [+] or if otherwise directed
by you, by monthly or weekly instalments, according
to your directions in that behalf: being
Your humble Servant
to command

Identifier: | JB/124/059/002 "JB/" can not be assigned to a declared number type with value 124.
Date_1		Marginal Summary Numbering	2-3
Box	124	Main Headings	panopticon
Folio number	059	Info in main headings field
Image	002	Titles
Category	text sheet	Number of Pages	2
Recto/Verso	recto	Page Numbering	d5 / d6
Penner	jeremy bentham	Watermarks
Marginals	jeremy bentham	Paper Producer
Corrections		Paper Produced in Year
Notes public		ID Number	41748
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