Form No 2

Declaration of                                            A44314

Memorialist.

 

Sold by

Evison & Bridge,

22 Chancery Lane

s471-5.

 

                         I Conrad Korzeniowski

                         of 6 Dynevor Road Stoke Newington

                        in the County of Middlesex

                        do solemnly and sincerely declare as follows:-

 

That the statements contained in the paper writing now produced and shewn to  me marked with the letter "A" purporting to be a Memorial addressed by myself to The Right Honourable Hugh Childers Her Majesty´s Principal Secretary of State for the Home Department praying for the grant of a Certificate of Naturalization under the provisions of the Act of Parliament made and passed in the 33rd year of the reign of Her present Majesty Queen Victoria Cap.14 intituled "An Act to amend the Law relating to the Legal Condition of Aliens and British Subjects" are true as therein set forth.

 

And I make this solemn Declaration conscientiously believing the same to be true and by virtue of the provisions of the Statutory Declarations Act 1835.

 

 

Declared at 54 ½ Bishopsgate

Street Within in the City

of London

this second day of                                                  Conrad Korzeniowski

July One thousand eight

hundred and eighty six

Before me

F Tensill

 

A Commissioner to adminster oaths

in the Supreme Court of Judicature