STATUTORY DECLARATION TO BE MADE BY ENUMERATOR
I, David Clement
(Name in full of Enumerator)
do hereby solemnly and sincerely declare that:-
(a.) I have enumerated every dwelling and building within my district.
(b.) I have delivered a Schedule to every Occupier within my district in accordance with Instructions 8 and 9 in the Memorandum Book, and have accounted for every Schedule so delivered.
(c.) I have correctly copied into this Summary Book from the Memorandum Book and from the Schedules the required particulars of the dwellings and population
(d.) I have checked all the additions and summarising in the Book.
(e.) 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 conscienctiously believing the same to be true and by virtue of the provisions of the Statutory Declarations Act, 1835.
Signature of Enumerator
To be signed in the presence of the Superintendent Registrar or Registrar
Declared and subscribed before me this 8th day of April 1911, in accordance with Section 11 of the Census (Great Britain) Act, 1910
Sarah E. Lewis
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:-
(a.) The casting of the population on each Schedule.
(b.) The copying of the particulars from the Memorandum Book and the Schedules into this Summary Book.
(c.) All the casting and summarising 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.
Sarah E. Lewis
Date 10th April 1911