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The Pamphlet Collection of Sir Robert Stout: Volume 63

Schedule Referred to

Schedule Referred to.

No. (Place and Date.) To the Warden at

I hereby apply for a lease of land for Agricultural purposes, situate at (here state the locality) and comprising acres, or thereabouts; and I deposit herewith the sum of five pounds to cover the costs of survey, and I agree to pay the further costs (if any) of such survey, according to the scale prescribed by the Agricultural Leases Regulations.

Signature [name in full, and address.]