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X-471

KNOW ALL MEN BY THESE PRESENTS:

as suret__, are held and firmly bound unto the UNITED STATES OF
AMERICA in the full and just sum of __________________________
_______________ _

dollars ($_____________ ) lawful money of

the United States; for which payment, well and truly to be made
we bind ourselves, jointly and severally, our joint and several
heirs, executors, and administrators, successors and assigns,
firmly by these presentsSealed with our seals, and dated this ____________ day of
_____________ , in the year .one thousand nine hundred and _____ ,

The condition of the above obligation is such, That whereas
under authority of an Act of Congress approved ____ .
___________
_______ , 19.17, the said ___________________________________ _ _
has filed an application with the Secretary of the Treasury,
through the Federal Reserve Board, for a license to export the
sum of $________________________




in gold to _________________

to be used for the following purposes:

X-471
- 2 WHEREAS, upon the recommendation of the Federal Reserve
Board, the Secretary of the Treasury has authorised the issuance
of such license, upon the condition, however, that the applicant
shall file with the Federal Reserve Board a bond running to the
United States in the penal sum of $__________________________
executed by the applicant as principal and by a surety approved
by the Federal ReseiVe Board and abnditionsd upon the submission
to the Federal Reserve Board within ninety days from date of sat­
isfactory evidence that said gold has been used for the purposes
above enumerated in tfye application.
NCW, THEREFORE, if the said ___________________________ _ _
_________________ shall, within ninety days from date, furnish
to the Federal Reserve Board through the Federal Reserve Bank sat­
isfactory evidence that the gold exported under the license

refer­

red to has been used for the purposes indicated in the application
and above set forth and for no other purposes, such evidence to be
in the following form,to wit: •

Then this bond shall be void and of none effect, otherwise it shall
remain in full force and effect.
Signed, sealed and delivered in
the presence of -




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