SCHEDULE (B.)
No.
In pursuance of an Act passd in the Forty eigith Year of the Reign of his present Majesty, intituled, .[here insert the Title of the Act.] I do hereby certify to the Governor and Company of the Bank of England, that A. B. of hath signified to the Commissioners for the Reduction of the National Debt, his [or her] Desire, on his; [or her] own Behalf [or, on the Behalf of C.D of ] to transfer the Sum of £. 3 per Centum., Consolidated [or, Reduced] Bank Annuities, to the said Commissioners, for, the Purchase of a Life Annuity on the Life of himself or herself [or, of C. D. as the Case.may be] [or, in case of Two .Nominees, on the Lives of him or her the said A. B. and of E. F. of. and the life of the longer, Liver of. them,] [or, of E. F. of and G. H. of and the Life of the longer Liver of them, as the Case-may be] And I do hereby further certify, That it hath. been made appear to me, that the Age of the said-Nominee, upon which the Amount of the said Annuity is,to be estimated according to the Provisions. of the said Act, is Years [or, in case of Two Nominees of equal Ages, that the said. Nominees are of equal Ages, and that the Age upon which the Amount of the said anuity is to, be estimated according to the [provisions of the said Act is. Years] [or, in case there sall be Two nomininees of unequal ages; that the respective Ages upon which the Annuity is to be estimated according to the Provisions of the said Act are as follows; videlicet, the Age of the said the younger Nominee, is Years; and the Age of the said the elder Nominee exceeds the said Age of the younger Nominee by more than Years, but not by more than Years]: And I do hereby further certify, that the Amount of the Life Annuity which will, upon the Transfer of the said Sum of £. 3 per Centum Consolidated [or, Reduced] Bank Annuities, become payable in respect thereof during the Life of the said Nominee [or, of the said Two Nominees and the Life of the longer Liver of them] is per Annum.
Witness my Hand this Day of
