Certificate to Authorize the Issue of a Grocer's or Colonial Wine License.

We the undersigned being the majority of the licensing magistrates assembled at the licensing meeting holden at on the____day of One thousand eight hundred and seventy-____the requisite notice of application for this certificate having been proved before us to have been duly served and posted do hereby authorize the issue to____of a grocer's [or colonial wine license as the case may be] for his house situate at Given under our hands the____day of One thousand eight hundred and seventy-