THE NEW ZEALAND GAZETTE. 85

No....... Folio......
REQUISITION A.-(From 1d. to 19s. 8d.)
REQUIRED by (1) ........................................
of (2) .....................................................
Adhesive Duties' Stamps of the following Numbers and
Denominations.
Denomi-
nation. Number. (3) Amount. Denomi-
nation. Number. (3) Amount.
£ s. d. £ s. d. £ s. d.
Carried fd. £ Brought fd.
Amount
Commission of 2½
per cent....
Net Amount
£

No.
REQUISITION A.-(From £1 to £10.)
REQUIRED by (1) ........................................
of (2) .....................................................
Adhesive Duties' Stamps of the following Numbers and
Denominations :-
Denomi-
Denomi-
nation. Number. (3) Amount. nation. Number. (3) Amount.
£ s. d. £ s. d. £ s. d.
Carried fd. £ Brought fd.
Amount
Commission of 2½
per cent.
Net Amount
£

No.
REQUISITION B.--- (Impressed Stamps.)
REQUIRED by (1) ........................................
of (2) .....................................................
Duties' Stamps of the following Numbers and Denomina-
tions to be impressed on the (3) transmitted
herewith: -
Numbers. Denominations. (3) Amount.
(In words at length.) (In figures.)
£ s. d. £ s. d.
Amount £
Commission at the rate of 50s. per cent.
for any sum not less in amount than £30
Net Amount £

Signature of Applicant ............................
Date .....................................................
(1) Christian and Surname at full length.
(2) Place of residence or business, and post town.
(3) State whether blank forms-paper or parchment.
NOTE.-Stamps for denoting duties without the aid of an
Adhesive Stamp, are impressed only at the Stamp Office,
Wellington.

No. ...... Folio ......
REQUISITION C.-(Adhesive Stamps to be Impressed.)
REQUIRED by (1) ........................................
of (2) .....................................................
Adhesive Duties' Stamps of the following Numbers and
Denominations to be impressed on the Deeds transmitted
herewith: -
Number. Denominations.
(In words at length.) (In figures.) Amount.
£ s. d. £ s. d.
Amount ................................................... £
Total... ................................................... £

Signature of Applicant ............................
Date .....................................................
(1) Christian and Surname at full length.
(2) Place of residence or business, and post town.
(3) In words at length.

No. ...... Folio ......
REQUISITION D.-(Adhesive Stamps to be Impressed.)
(Probate and Administration Duties.)
REQUIRED by (1) ........................................
of (2) .....................................................
Adhesive Duties' Stamps of the following Numbers and
Denominations to be impressed on the Deeds transmitted
herewith.
Numbers. Denominations. (3) Amount.
£ s. d. £ s. d.
1 0 0
1 10 0
2 0 0
3 0 0
4 0 0
4 10 0
5 0 0
6 0 0
7 10 0
Fines ................................................... £
Amount ................................................... £

Where the sum sworn under to obtain Probate shall
be of the amount of £500 and upwards, a duty
of £1 per cent. has to be calculated and paid.
Here set out the amount (in
words at full length), the
goods, &c., of the deceased
are sworn under the value of
cent.

Where the sum sworn under to obtain Letters of
Administration shall be of the amount of £500
and upwards, a duty of £1½ per cent. has to be
calculated and paid.
Here set out the amount (in
words at full length), the
goods, &c., of the deceased
are sworn under the value of
Fines ................................................... £
Amount ................................................... £