STATUTORY DECLARATION TO BE MADE BY THE ENUMERATOR.
Thomas Shorrock(name in full of enumerator)do hereby solemnly and sincerely decalare that:-
I have enumerated every building and dwelling within my district.
I have delivered a Schedule to every Occupier within my district in accordance with Intructions 8 and 9
in the Memorandum Book, and have accounted for every Schedule so delivered.
I have correctly copied into this Summary Book from the Memorandum Book and from the Schedules
the required particulars of the dwellings and population.
I have checked all the additions and summarising in this book.
The returns furnished by me in pursuance of the Census (Great Britain) Act, 1910, or the Instructions
issued thereunder have been truly and faithfully taken, and to the best of my knowledge they are
correct so far as may be known.
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.
Signature of Enumerator
Declared and subscribed before me the 10th day of
April, 1911, in accordance with Section 11 of the
Census (Great Britain) Act, 1910.
(To be signed in the presence of the Superintendent Registrar
REGISTRAR'S CERTIFICATEI certify that:-
To the best of my belief no dwelling or building within the Enumeration District has been omitted.
I have checked:-
The casting of the population on the Schedule.
The copying of the particulars from the Memorandum Book and Schedules into this Summary
All the casting and summarizing in this book.
I have satisfied myself that the dwellings and population in this District have been assigned to their correct