Witness my hand this —— day of ——, in the year of our Lord 18—.
[Signature and address of] C. D.
Declaration [to be written at the foot of the Nomination].
“We the before-named C. D. and A. B. do declare to the said Lord Bishop of ——, as follows; namely, I the said C. D. do declare that I bonâ fide intend to pay, and I the said A. B. do declare that I bonâ fide intend to receive, the whole actual stipend mentioned in the foregoing nomination and statement, without any abatement in respect of rent or consideration for the use of the glebe-house, garden, and offices thereby agreed to be assigned, and without any other deduction or reservation whatsoever.
Witness our hands this —— day of ——, 18—.
[Signatures of] C. D.
A. B.”
6. (a) The form of nomination to serve as a title for orders, if the incumbent is resident.
The same form as No. 6, so far as “quarterly payments;” then proceed as follows:—And I do hereby state to your lordship, that the said A. B. intends to reside in the said parish, in a house [describe its situation, so as clearly to identify it], distant from my church —— mile [if A. B. does not intend to reside in the parish, then state at what place he intends to reside, and its distance from the said church]; that the said A. B. does not intend to serve, as curate, any other parish, nor to officiate in any other church or chapel (if such be the fact, otherwise state the real fact); and I do hereby promise and engage with your lordship, and so on [in the same form as No. 6, to the end].
Witness my hand this —— day of ——, 18—.