And whereas, at the hearing of the said summons, it has
now been proved to the satisfaction of the Court that the
defendant [Here specify such of the matters stated in the summons as have been proved], and the defendant has shown no
cause why he should not be committed to prison:

Now, therefore, it is ordered that, unless the defendant
shall pay into this Court at [forthwith or on or before the day of , 18 , or by instalments of £ on the day of , 18 ] the sum[s] so due and payable as aforesaid, together with the prescribed costs, or
shall file such affidavit as is mentioned in Rule 23 of the
Rules for Resident Magistrates' Courts under "The Imprisonment for Debt Abolition Act, 1874," he shall be committed
to the public prison at , known as , for

Given under my hand this day of , 18 .

Resident Magistrate.

Amount of judgment or order remaining due ..
Cost of judgment summons ..

Amount upon the payment of which the prisoner
is to be discharged ..

(Subject as above, this order remains in force one year
from the date thereof.)

(Indorsement.)

In the Court of , holden at
Between A.B., Plaintiff,
and
C.D., Defendant.

I, , bailiff of the Resident Magistrate's Court holden
at , do hereby make oath and say:

1. That I duly served the within , the defendant,
   with an order of commitment, a true copy of which said
   order appears on the other side hereof, marked "A," by delivering the same to him personally at , on the
   day of , 18 .

Sworn at this
day of , 18 ,
before me.

[I. Debt 9.

CERTIFICATE AS TO PAYMENT BY A DEFENDANT.

"The Imprisonment for Debt Abolition Act, 1874."

I HEREBY certify that the defendant, who was committed to
my [or your] custody by virtue of a warrant of commitment
issued out of this Court [or of the Court of , holden at ], bearing date the day of , 18 , has paid and satisfied the sum of money for the non-payment whereof he was so committed, together with all
costs due and payable by him in respect thereof; and that
the defendant may, in respect of such order, be forthwith
discharged out of my [or your] custody.

Given under my hand [or the seal of the Court] this
day of , 18 .

Gaoler [or Clerk of the Court
holden at .]

To

[I. Debt 10

WARRANT OF COMMITTAL.

In the Resident Magistrate's Court of , holden at
To , the bailiff of the Resident Magistrate's Court
of , and to , the Gaoler or keeper of the
Prison at , known as

GREETING:

Between A.B., Plaintiff,
and
C.D., Defendant.

WHEREAS by an order bearing date the day of
18 , and issued out of this Court, it was ordered that, unless the defendant should pay into this Court, at
[Copy exact terms of order], the sum[s] so due and payable
as aforesaid, together with the prescribed costs, or should file
such affidavit as is mentioned in Rule 23 of the Rules for
Resident Magistrates' Courts under "The Imprisonment for
Debt Abolition Act, 1874," he should be committed to the
public prison at , known as for

And whereas such order was duly served on the defendant
upon the day of , 18 :

And whereas the defendant has not paid the sum[s] in
the said order mentioned in the manner therein directed,
but therein has made default, and there is now due and
owing under the said order the sum stated below:

These are therefore to require you, the said , and
others, to take the defendant and deliver him to the Gaoler
or keeper of the prison known as , at , and
you, the said Gaoler or keeper, to receive the defendant,

and him safely keep in the said prison for
from the
date of his arrest under the said order, unless he shall
sooner pay the sum stated below as that upon payment
of which he is to be discharged, or be otherwise discharged
by due course of law.

Given under my hand this day of , 18 .

Chief Clerk of the Court.

£ s. d.

Amount of judgment summons remaining due ..
Costs of warrant of committal ..

Amount upon the payment of which the defendant is to be discharged ..

[I. Debt 11.

AFFIDAVIT (AS TO BANKRUPTCY).

"The Imprisonment for Debt Abolition Act, 1874."

In the Court of , holden at
Between A.B., Plaintiff,
and
C.D., Defendant.

I, C.D., of , make oath and say,

1. That under "The Imprisonment for Debt Abolition
   Act, 1874," a warrant for my committal to prison was made
   by the above Court [or the Court of , holden
   at ], for making default in payment of £ , due
   from me in pursuance of an order [or judgment] of the
   [Here insert the Court in which order or judgment was
   given].

2. That on the day of , 18 , I was adjudicated a bankrupt by the [Here insert title of Court by
   which adjudication was made].

3. That the order of adjudication was published in the
   [Naming the newspaper] on the day of , 18 .

4. That the debt in respect of which the above order [or
   judgment] was given was provable under the said bankruptcy.

Sworn at , this
day of , 18 , before me--

C.D.

[I. Debt 12.

CERTIFICATE.

"The Imprisonment for Debt Abolition Act, 1874."

In the Court of , holden at
Between A.B., Plaintiff,
and
C.D., Defendant.

I HEREBY certify that the defendant, who was committed
to your custody by virtue of a warrant of committal issued
out of the Court of , holden at ,
bearing date the day of , 18 , has filed an
affidavit in this Court stating that he has been duly adjudged a bankrupt, and that the debt in respect of which
the said warrant of committal was made was provable under
the said bankruptcy. And I do further certify that the defendant may, in respect of such order, be forthwith discharged out of your custody.

Given under the seal of the Court, this day of
, 18 .

Registrar [or Clerk] of the Court.

To the Gaoler or Keeper of the
Prison at

SECOND SCHEDULE.

TABLE OF FEES TO BE TAKEN IN THE RESIDENT MAGISTRATES' COURTS UNDER "THE IMPRISONMENT FOR DEBT ABOLITION ACT, 1874."

On Amount
unpaid
not exceeding

£ £ £ £ £
5 10 20 50 100

s. s. s. s. s.

Summons, service, hearing, and order .. 5 8 15 20 30
Summons for each witness .. 3 3 3 3 3
Service of summons to witness within two
miles of Court .. 2 2 2 2 2
Adjournment of hearing on application of
either party .. 1 2 3 4 5
Warrant of committal .. 3 4 5 6 7
Certificate or order for discharge .. 2 4 6 8 10
Certificated copy of order or judgment .. 2 3 4 5 6