Form, printed with manuscript additions. Prisoners, (Temporary discharge for ill health) Act 1913, Notice to be given to prisoner. Filled out in name of George Clancy, 21st Nov. 1917, for release from Cork prison. Conditions listed, 1 that he must return on 12th Dec 1917 unless discharge extended, 2 period of discharge can be extended by Lord Lieutenant, 3 that he must abstain from violations of the law and 4 (added in ms) that he shall attend any proceedings in his case where his attendance is required. Unclear signature of prison governor. One side of a single sheet, printed in black by A. P.W. Co Ltd. has been folded several times and now weak along folds, especially the central vertical one; left edge slightly ragged from short tears.