LAND and HEREDITAMENTS in which the above-named

• Parish is interested, situated in the*

or

Township County of

and

in the

and proposed to be exchanged

Parish. for the land and hereditaments hereinafter specified.

NOTE.-If the lands to be exchanged form part of an estate, it is desirable, for the sake of identity, that this should be stated; for the same reason, in exchange of cottages, gardens, or pieces of land not known by particular names, the occupiers' names should be given. When lands are in more than one parish, the land of each parish must be kept distinct. Every parcel held under a different title, or for a different estate, as well as the land for which such parcel is exchanged, must be separately entered in the application, and the respective values of each must be shown to be equal.

and

Parish. for the lands and hereditaments before specified.

in the year

WITNESS our hands to the foregoing application this

day of

of our Lord one thousand eight hundred and

The consent of the Bishop of the Diocese, and Patron of the Benefice, being necessary where lands are held in right of any Church, Chapel, or other Ecclesiastical Benefice, should be given as follows:

We, the undersigned

the Diocese of

of

Lord Bishop of

and

in the county of

Patron of the Benefice herein before mentioned, do hereby consent to the foregoing application.

(Signed)

The consent of the lord of the manor, being necessary to the exchange of copyhold or customary land, should be given as follows:

I, the undersigned

of

in the county of

lord of the manor of

aforesaid, do hereby consent to the foreging application.

(Signed)

interested under the provisions of "The Acts for the Inclosure, Exchange and Improvement of Land," in

undivided

parts or shares in the lands and hereditaments and I the undersigned

hereinafter mentioned,

of

being

the person interested under the provisions of the said Acts in the remaining undivided part or share in the same lands and hereditaments, and being desirous of effecting a partition, as hereinafter mentioned, hereby apply to you to direct inquiries whether such proposed partition would be beneficial to the respective owners of such undivided parts; and, in case you should be of opinion that such partition would be beneficial, and the terms thereof just and reasonable, to proceed with the same under the provisions of the said Acts.

LANDS and HEREDITAMENTS proposed to be allotted in severalty to the above-named

situate in the parish of

in the county of