Take Notice, if this Declaration is false the person making it is punishable for perjury.

        Unless this printed form is taken before a Magistrate and declared to and signed, and delivered back to the pawnbroker not later than                                 20     , the articles mentioned in it will be delivered to any person producing the pawn ticket.

        I, A.B., of                                      , in pursuance of the Pawnbrokers Act (Chapter 222), do solemnly and sincerely declare that the article [or articles] described below is [or are] my property and that I believe it is [or they are] pledged at the shop of                                         

       The article [or articles] above referred to is [or are] the following:

       And I, C.D., of                             , in pursuance of the said Act, do solemnly and sincerely declare that I know the person now making the foregoing declaration to be A.B., of                                 

       Declared before me this           day of           20               .

 

      Take Notice, if this Declaration is false the person making it is punishable as for perjury.

       Unless this printed form is taken before a person authorised to administer oaths or a Notary Public and declared to and signed, and delivered back to the pawnbroker not later than 20 , the articles mentioned in it will be delivered to any person producing the pawn ticket.

       I, A.B., of                                                  , in pursuance of the Pawnbrokers Act (Chapter 222), do solemnly and sincerely declare that pledged at the shop of                                  , pawnbroker, the article [or articles] described below being                             property and received a pawn ticket for the same, which has since been by                            , and that the pawn ticket has not been sold or transferred to any person by                                   or to                 knowledge or belief.

       The article [or articles] above referred to is [or are] the following :

       Declared before me this         day of           20           .