THE NEW ZEALAND GAZETTE.
551

Estates in New Zealand duly authorized by
law to receive the same.
(c.) Where the whole legal right to the moneys
secured has been assigned to some person still
living, in accordance with the provisions of the
said Acts, or of any Regulations for the time
being relating to such transfers.
50. All powers of attorney, probates, letters of
administration, exemplifications, or other formal
proofs, orders of Courts and other instruments,
evidencing the right of any person to receive any
money under any contract of the said Commissioner,
shall be produced to the said Commissioner, or to
such person as he shall in each case appoint.
51. The contract shall be given up when the
money payable thereunder by the said Commissioner
is paid.
52. The said Commissioner may accept proofs of
age and identity or death other than as aforesaid,
which shall to him appear substantially sufficient for
any of the said purposes.
53. All proofs shall be made at the expense of the
person tendering the same.
54. Immediately after due proof of death shall
have been supplied, and the Regulations in other
respects complied with, the moneys payable under
the contract shall be paid by the said Commissioner.

FORSTER GORING,
Clerk of the Executive Council.

SCHEDULE OF FORMS.

Form of Contract for Purchase of Immediate or Deferred
Annuity by a Single Payment.

WHEREAS under the provisions of "The Government Annuities
Act, 1869," and "The New Zealand Government Insurance and
Annuities Act, 1870," William Gisborne, of the City of Wel-
lington, Esquire, has been duly appointed and is now acting as
Government Annuities Commissioner for the purposes of the
said Acts: And whereas
of has contracted with
the said Commissioner for the purchase of one Annuity or yearly
sum of £ to be paid to as hereinafter mentioned,
by equal half-yearly payments, and has deposited with the said
Commissioner a proposal and declaration dated the
of
day
one thousand eight hundred and , and signed
by the said as the basis of the contract for the purchase
of such Annuity, in which proposal it is stated, amongst other
things, that the age of the said is not less than years :
And whereas the said has paid to the said
Commissioner the sum of £ as the consideration for the
said Annuity:-Now it is hereby declared that the said Com-
missioner shall, pursuant to the said Act, be subject and liable to
pay to the said during his life the annual sum of £
by equal half-yearly payments on the day of
and
the day of in each year, the first payment
thereof to be made on the day of if the
said be then living, without any deduction or abate-
ment whatever.

But this contract is made subject to the following con-
ditions:-
1st. No payment of the said Annuity shall be claimed or
be recoverable until the said shall to the satis-
faction of the said Commissioner have proved himself to
be alive at the date of such payment becoming due.
2nd. This contract shall be void, and all moneys paid
thereunder by the said shall be forfeited, if the
age of the said have been less than years at
the date of this contract.

In witness whereof the said Commissioner hath here-
unto set his hand and seal the day of
one thousand eight hundred and

Signed, sealed, and delivered
by the said Commissioner,
in the presence of

Form of Contract for Purchase of Deferred Annuity by
Payment of Annual Premiums.

WHEREAS under the provisions of "The Government Annuities
Act, 1869," and "The New Zealand Government Insurance and
Annuities Act, 1870," William Gisborne, of the City of Wel-
lington, Esquire, was duly appointed and is now acting as Go-
vernment Annuities Commissioner for the purposes of the said
Acts: And whereas
of
has contracted with the
said Commissioner for the purchase of one annuity or yearly
sum of £ to be paid to
by equal half-yearly
payments, as hereinafter mentioned, and has deposited with the
said Commissioner a proposal and declaration dated the
day of
one thousand eight hundred and
and
signed by the said
as the basis of the contract for the
purchase of such Annuity, in which proposal it is stated amongst
other things, that the age of is not less than years:
And whereas the said has paid to the said Commissioner
the sum of £ if the sid under the said contract:-Now it is hereby declared that
shall pay to the said Commissioner the sum
of £ day of next ensuing, and
the like sum on the day of in every subse-
quent year up to the day of one thousand eight
hundred and
then the said Commissioner shall, pur-
suant to the said Act, be subject and liable to pay to the said
during his life, and without any deduction, the annual
sum of £ by equal half-yearly payments on the
and the day of in each year, the first payment
thereof to become due and be made on the
day of next after the last payment of premium shall
have been made if the said be then living.

But this contract is made subject to the following con-
ditions:-
1st. No payment of the said Annuity shall be claimed or
recoverable until the said
shall to the satisfaction
of the said Commissioner have proved himself to be alive
at the date of the payment becoming due.
2nd. This contract shall be void, and all the sums paid
under it on account of the purchase money shall be for-
feited, if the age of be less than years at
the date of contract.

In witness whereof the said Commissioner hath here-
unto set his hand and seal the day of
one thousand eight hundred and

Signed, sealed, and delivered
by the said Commissioner,
in the presence of

Form of Contract for the Insurance of Life by a Single
Premium.

WHEREAS under the provisions of "The Government Annuities
Act, 1869," and "The New Zealand Government Annuities and
Insurance Act, 1870," William Gisborne, of the City of Wel-
lington, Esquire, has been appointed Government Annuities
Commissioner for the purposes of the said Acts: And whereas
the said Commissioner is authorized to execute contracts for the
insurance of lives: And whereas herein-
after called "the Assured," has contracted with the said Com-
missioner for an Insurance of the sum of £ on his own
life, and has deposited with him a proposal and declaration, dated the
day of one thousand eight hundred
and and signed by him, as the basis of the contract
for such Insurance, and has also made certain statements and
a declaration dated the day of one thousand
eight hundred and to a Medical Examiner: And whereas
the said Assured has paid to the said Commissioner the
sum of £ as the entire premium for such Assurance:--
Now it is hereby declared that on the death of the said Assured
the said Commissioner shall, pursuant to the said Act, be subject
and liable to the payment unto the executors, administrators, or
assigns of the said Assured, immediately after satisfactory
proof of his death shall have been received by the said Com-
missioner of the sum of £

But this contract is made subject to the condition that it
shall be void, and all the payments made by or on behalf of the
said Assured under it shall be forfeited, in any of the following
cases:--
1st. If the statements of the Proposer, as set forth in the
proposal, or of the person or persons examined by the
Medical Examiner, as set forth in the medical examina-
tion, or any of such statements respectively, be untrue,
or if any person whose life is assured has wilfully with-
held any information required of him.
2nd. On default of payment of the annual or other
periodical payment to be made thereunder.
3rd. If the person, or any of the persons upon the contin-
gency of whose life or lives the particular transaction
is to depend, shall go or travel beyond the limits allowed
by the Regulations without the leave of the said Com-
missioner.
4th. If the Assured shall adopt any trade or occupation
declared by the said Commissioner to be hazardous
without the leave of the said Commissioner.
5th. If the Assured shall die by his own hand, or by
dueling within twelve months, or by the hands of
justice.