| Filename | Brittain_220_3_2018-07-11_0027 |
| Title | Blank statement with handwritten notes |
| Front/Back | Front |
| Blank | No |
| Author | Norman Montgomery |
| Date | |
| Type | Note |
| Country | Canada |
| State | Ontario |
| County | |
| Township | |
| Lot | |
| Concession | |
| OGSRA Well Ind | No |
| Quality Score | 2 |
| Documentation Score | 2 |
| Description | A blank statement from Norman Montgomery with handwritten notes. |