STATUTORY DECLARATION TO BE MADE BY THE ENUMERATOR.

I,

Samuel Henry Schofield
(name in full of enumerator) do hereby solemnly and sincerely decalare that:-
  1. I have enumerated every building and dwelling within my district.
  2. 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.
  3. I have correctly copied into this Summary Book from the Memorandum Book and from the Schedules the required particulars of the dwellings and population.
  4. I have checked all the additions and summarising in this book.
  5. 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 Samuel Henry Schofield
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Declared and subscribed before me the 7th 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 or Registrar.)
Registrar.
George L Flint
REGISTRAR'S CERTIFICATE I certify that:-
  1. To the best of my belief no dwelling or building within the Enumeration District has been omitted.
  2. I have checked:-
    1. The casting of the population on the Schedule.
    2. The copying of the particulars from the Memorandum Book and Schedules into this Summary Book.
    3. All the casting and summarizing in this book.
  3. I have satisfied myself that the dwellings and population in this District have been assigned to their correct local sub-divisions.

George L Flint

Registrar.

Date 28th April 1911

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