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Highway Act 1835

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(to wit.) Be it remembered, That on the _______________ Day of _______________ A.B. of _______________ in the said County, informeth and maketh Oath before me _______________ One of His Majesty's Justices of the Peace for the said County, that _______________ of _______________ in the said County, [here describe the Offence, with the Time and Place, and follow the Words of the Act as near as may be,] contrary to the Statute in the Fifth and Sixth Year of the Reign of His Majesty King William the Fourth, intituled, " An Act," &c. [here set out Title of Act,] which hath imposed a Forfeiture _______________ for the said Offence. Taken and sworn the _______________ Day Of _______________ before me ______________________________ A. B. No. 22

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