JB/119/214/003

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Forms.
Superannuation An.

Panopticon Bill.

Art.7. This Deed is good & binding although it
be not like other Deeds on a Stamp: being in your
favour excused therefrom. [3A. Geo: 3.ch. SS art. 6.]

[C.2]

Petition for Remittance from a Superannuation Annuitant.

To the Governor of the General Panopticon Penitentiary
House.

Honoured Sir

[Town County this day of Mth yr.]
a Half-yearly payment or [Half
yearly payments] of my Superannuation Annuity
having become due [or about to be due] the day of
[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 for my use to [] Witness the
hand of

Your dutiful & grateful Servant
R. A.

Identifier: | JB/119/214/003"JB/" can not be assigned to a declared number type with value 119.
Date_1		Marginal Summary Numbering
Box	119	Main Headings	panopticon
Folio number	214	Info in main headings field	panopticon bill
Image	003	Titles
Category	copy/fair copy sheet	Number of Pages	4
Recto/Verso	recto	Page Numbering
Penner		Watermarks
Marginals		Paper Producer
Corrections		Paper Produced in Year
Notes public		ID Number	39725
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