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A.D. 1875.

of

Form of objection.

To the chairman of the local board of the district

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I hereby give you notice that I object to the name of the person mentioned and described below being retained on the register of owners and proxies for the district of

of

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To the chairman of the local board for the district

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to

I [or we] the undersigned being the owner [or owners] of the property herein-after described which is situated in the parish of do hereby appoint vote as my [or our] proxy in all cases wherein he may lawfully do so, pursuant to the provisions of the Public Health Act 1875. And I [or we] hereby state that the description of the said property is as follows; viz. (a)

Signature of owner (b).
Address of owner.
Witness.

(a) Describe the property by its name, situation, or the name of the occupier, or any other designation by which it may be identified.

(b) Or of three directors; or in the case of a corporation say, Given under our common seal, and add the name of the person or persons entitled to affz the seal.

FORM N (see Sch. II., 43, ante, p. 312).

Form of Voting Paper at Elections of Members of Local Boards.
Voting Paper.

District of

A.D. 1875.

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I vote for the persons in the above list against whose names my initials are placed.

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The voter must write his initials against the name of every person for whom he votes, and must subscribe his name and address at full length.

If the voter cannot write he must make his mark instead of initials, but such mark must be attested by a witness, and such witness must write the initials of the voter against the name of every person for whom the voter intends to vote.

If a proxy votes he must in like manner write his initials, subscribe his own name and address, and add after his signature the name of the body of persons for whom he is proxy.

This paper will be collected on the between the hours of

and

of

A.D. 1875.

FORM O (see Sch. III., 6, ante, p. 327).

Form of Voting Paper for Poll taken under Schedule III.

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66

(Signed)

or the mark of Witness to the mark

or proxy for

Directions to the Voter.

The voter must write his initials under the heading "in favour" or against," according as he votes for or against the resolution, and must subscribe his name and address at full length.

If the voter cannot write he must make his mark instead of initials, but such mark must be attested by a witness, and such witness must write the initials of the voter against his mark.

If a proxy votes he must in like manner write his initials, subscribe his own name and address, and add after his signature the words "as proxy for," with the name of the body of persons for whom he is proxy.

This paper will be collected on the

between the hours of

and

of

SCHEDULE V.

PART I.

Enactments which have been already repealed are in a few instances included in this repeal, in order to avoid the necessity of reference to previous statutes.

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The Diseases Preven-
tion Act, 1855.
The Nuisances Re-
moval Act for Eng-
land, 1855.
The Local Govern-
ment Act, 1858.
An Act to amend the
Acts for the Re-
moval of Nuisances
and the Prevention
of Diseases.

The Local Government
Act (1858) Amend-
ment Act, 1861.
The Local Government
Act Amendment
Act, 1863.
The Nuisances Re-
moval Act for Eng-
land (Amendment)
Act, 1863.
The Sewage Utiliza-
tion Act, 1865.

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30 & 31 Vict. c. 113.

31 & 32 Vict. c. 115.

The

1868.

The whole Act, except
so far as relates to the
Metropolitan Police
District.

The whole Act, except
so far as relates to the
Metropolitan Police
District.

The whole Act, except
so far as relates to the
Metropolis.

The whole Act, except
so far as relates to
the Metropolis.
The whole Act.

The whole Act, except
so far as relates to
the Metropolis.

The whole Act.

The whole Act.

The whole Act, except
so far as relates to
the Metropolis.

The whole Act, except
so far as relates to
Scotland and Ireland.
The whole Act, except
so far as relates to
the Metropolis.
Parts I., II., and III.,
except so far as re-
lates to the Metro-
polis or to Scotland
or Ireland.

The whole Act, except
so far as relates to
Scotland or Ireland.

Sanitary Act, The whole Act, except

so far as relates to
the Metropolis.

A.D. 1875.

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Of the above Acts, the following, (namely,) "The Public Health Act, 1848," and "The Local Government Act, 1858," and "The Local Government Act (1858) Amendment Act, 1861," and " The Local Government Act Amendment Act, 1863," are in this Act referred to as "The Local Government Acts."

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