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FIFTH SCHEDULE.
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Form marked A.
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Sect. 36.
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The Housing of the Working Classes Act, 1890.
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County of
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Parish of
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No.
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Charging Order.
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Insert description of local authority.
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The being the local authority under the above-mentioned Act, do, by this Order under their hands and seal, charge the inheritance or fee of the premises mentioned in the schedule hereto with the payment to of the sum of pounds payable yearly on the day of for the term of years, and being in consideration of an expenditure of pounds incurred by him in respect of the said premises.
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Form marked B.
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Sect. 37.
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Form of Assignment of Charge. To be endorsed on Charging Order.
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Insert description of premises charged.
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Dated the day of
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I, the within-named in pursuance of the Housing of the Working Classes Act, 1890, and in consideration of pounds this day paid to me, hereby assign to the within-mentioned charge.
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(Signed)
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