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I declare that:-
(a) I require the copy solely for the purposes of research or private study or
for a non-commercial purpose.
(b) I will not supply a copy of it to any other person.
(c) I have not previously been supplied with a copy of the same material by the
Record Office or anyone else.
(d) To the best of my knowledge the work had not been published before the
document was deposited in the Record Office, and the copyright owner has not
prohibited copying of the work.
I understand that if the declaration is false in a material particular the copy
supplied to me by you will be an infringing copy, and that I shall be liable
for infringement of copyright as if I had made the copy myself.
Signature*:............................................................
Date:........................................................
*This must be the personal signature of the person making the request. A
stamped or typewritten signature, or the signature of an agent, is NOT
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