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Printed declaration from John Brogey of New Chum Gully declaring that he is under the age of 33 years and that his wife does not exceed 28 years and that they do not have any infirmity likely to shorten the natural duration of life. Also signed by H. L. Atkinson that he has examined the Candidate and to the best of his belief, he is quite free of any infirmity which would tend to shorten the natural duration of life. Dated 13 Feb 1864.
