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VI FormsNo 2 V Requiem
2
Petition for
Remittance
<head>C2/head>
Form of a Petition for Letter of Request Remittance from a Requiem Superannuation
Annuitant requesting praying an order a remittance of
his Annuity through the Post-Master of a
neighbouring Town.
To the Governor of the National General<add> Panopticon Penitentiary House
Honoured Sir
[Town County this day of Day Month Year]
A [Quarter] Require
A Quarterly <add>Half-yearly payment or [Quarterly Half-yearly/add>
payments] of my Requiem <add>Superannuation Annity, being having become,
due [or about to be due] the day of [Month[[Year Month Year]
[ Month ] [ Year ] and I being settled at or in the
neighbourhood of the Town of [ ] in the County
of [ ] and it being particularly convenient to me to receive
such payment at the said Town [or at the Town of] [ ] I do
hereby humbly request you to cause the said Sum
to be remitted to for my use to [ ]
Postmaster for the said Town of [ ] Witness the hand
of Your dutiful and grateful Servant
3
Certificate for
County Post Master
of identity of
a Petitioners
Remittance
No 3
[C3]
Identity-Certificate from a Post Master
Certificate of the existence from the Post
Master of the true of and identity of the in favour of a Requiem Superannuation Annuitant to be annexed to
person signing a Letter as above purporting his petition for remittance. for
to be named on the Letter of a Requiem Annuity requesting
the remittance of his Annuity.
Sir To
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059 |
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2 |
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jeremy bentham |
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41748 |
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