Ontario, County of...

to wit:

I, C. D., of the......of

......, in the county of ......, the mortgagee in the within bill of sale, by way of mortgage named, make oath and say, that A. B., the mortgagor in the within bill of sale, by way of mortgage named, is justly and truly indebted to me, this deponent C. D., the mortgagee therein named, in the sum of $..., mentioned therein. That the said bill of sale, by way of mortgage, was executed in good faith, and for the express purpose of securing the payment of the money so justly due, as aforesaid, and not for the purpose of protecting the goods and chattels mentioned in the said bill of sale, by way of mortgage, against the creditors of the said A. B., the mortgagor therein named, or preventing the creditors of such mortgagor from obtaining payment of any claim against him.

C. D.

Sworn before me, at the....of......, in the county of

...., this...day of...., 18..

E. F., a Commissioner.