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District Court Rules
Schedule: C - Forms in civil proceedings Form: 83.2 Certificate to accompany application for (renewal of) certificate of registration - Registration of Clubs Acts, 1904 to 1988
No. 83.2
O.83, r.4 (3) (c)
Registration of Clubs Acts, 1904 to 1988
Certificate to accompany application for † (renewal of) certificate of registration
District Court Area of
District No.
We, Peace Commissioners for ........ *(and I, ........ owner of the premises occupied by the Club hereinafter mentioned) hereby certify that, to the best of our knowledge and belief, the ...... Club designated in the accompanying application has been and is to be conducted as a bona fide Club, and not mainly for the supply of excisable liquor.
Signed ........
Peace Commissioner
Address .........
Date .........
Signed ...........
Peace Commissioner
Address ..............
Date ............
*Signed ............
Owner of Club Premises
Address ..........
Date .........
† Delete if not required
* Delete where premises is owned by Club
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