6. Summons to Juror.

In the Warden's Court of____holden at____You are hereby summoned to appear and serve as a Juror in this Court, at the (Court-house) on the____day of____18____, at the hour of in the____noon, upon the trial of the cause or causes to be then tried by a Jury, and in default of attendance you will be liable to a penalty of Five Pounds, under section 54 of the "Gold Fields Act, 1862."

Dated this____day of____18.