¶ A Certificate of what hath been done upon the Poll-money, as well upon the Act of Poll-money, as upon the Order of Review of the same.  
COMMONS HOUSE.  
IMprimis, The charge of each several division amounteth in the total sum unto—  

The discharge of the said total sum appeareth in the particulars following, (Viz)  
1 Money paid into the Chamber of London—  
2 Money paid for the Collecting and paying of the same, according to the Statute or Order of review—  
3 In Certificates seen and allowed according to the said Statute, the sum of money is—  
4 In pretended Certificates neither seen nor allowed, the sum is—  
5 Moneys uncollected, and not distreined by reason of the poverty of the party assessed—  
6 Such as are dead and were able to pay in their life time—  
7 Refusers, that do not, or will not pay, although able and sufficient, whose names with the sums of money assessed upon them are in a Schedule annexed hereunto, amounteth unto—  
8 Memorandum, All that are assessed under twelve pence are not to be particularly named or written, but the total sum in every Parish or Township therein set down, The gross sum whereof is—  
9 You shall likewise certify where any considerable partiality or connivance hath been used, either by the Commissioners or Assessors, and in such case you are to certify the particular persons name and place of abode, that so such person may receive his condign censure.   
H. Elsing Cler. Parl. D. Com.   

¶ Imprinted at London by Robert Barker, Printer to the Kings most Excellent Majesty: And by the assigns of JOHN BILL. 1641.