Form No. 15, Rule 23.—Certificate of Succession Realty.

In the matter of the land known as_____, situation at_____, and of the estate, share, or [unclear: interest], deceased, therein.

At a sitting of the Court held at_____, before Esquire, Judge, and_____, Assessor:

It is hereby certified that_____, aboriginal natives, are the persons who are entitled to succeed to the estate, [unclear: share,] interest of and in the said land whereto the deceased da entitled, and that the deceased died on the_____, day of_____, one thousand eight hundred and_____,.As witness the hand of_____, Esquire, Judge, and the seal of the Court, this_____, day of_____, 189._____, Judge.