STATUTORY RULES.
1916. No. 131.
PROVISIONAL REGULATION UNDER THE WAR CENSUS ACT 1915-1916.
I, SIR ARTHUR STANLEY, Governor of the State of Victoria and its Dependencies, in the Commonwealth of Australia, acting as the Deputy of the Governor-General, in accordance with the provisions of the Constitution, acting with the advice of the Federal Executive Council, hereby certify that, on account of urgency, the following Regulation under the War Census Act 1915-1916, should come into immediate operation, and make the Regulation to come into operation forthwith as a Provisional Regulation.
Dated this twenty-eighth day of June, 1916.
A. L. STANLEY,
Deputy of the Governor-General.
By His Excellency’s Command,
H. MAHON,
Acting Attorney-General.
_______________
For the purposes of the War Census, authorized by Proclamation of the 28th day of June, One thousand nine hundred and sixteen, the form contained in the First Schedule, as modified by Statutory Rules 1915, Nos. 138 and 261, is further modified to read as follows:—
THE DEFENCE OF AUSTRALIA AND THE EMPIRE.
The Call to Arms.
Write in your answers legibly, place in small envelope, and deliver or post the envelope to Commonwealth Statistician, Melbourne. Do this at once.
Replies to these questions will be treated as strictly confidential.
Post answers to Commonwealth Statistician within seven days after receiving this Form.
Fill In the information required, on the proper line.
Name In full
(Correct this if not properly written.)
Give your usual postal address
State—
Reference Number | |
|
|
|
|
ENLISTMENT. | |
N.B.—If you have already enlisted please state date of enlistment and camp at which stationed. | |
Age last birthday
If unmarried, married, divorced, widowed
Number fully dependent on you
Number partly dependent on you
Present condition of your health, whether good, indifferent, bad
If deaf, blind, or if you have lost arm or leg
Your occupation
Are you willing to enlist now: Reply “Yes” or “No”
If you reply “Yes” you will be given a fortnight’s notice before being called up.
If not willing to enlist now, are you willing to enlist at a later date? Reply “Yes” or “No”, and if willing, state when.
If not willing to enlist, state the reason why, as explicitly as possible.
Signature
(Write distinctly.)
Date
(If reply is not received by due date prosecution will follow.)
_____________________________
Printed and Published for the Government of the Commonwealth of Australia by Albert J. Mullett, Government Printer for the State of Victoria.
C.8459.—Price 3d.