THE NEW ZEALAND GAZETTE. 793

Under those provisions, it becomes your duty, as such
Administrator, within six months from the grant of Administration,* to file with the Commissioner or Deputy Commissioner a statement in writing (form L) in respect of the property† to which such Administration relates, and to pay the amount of such duty as may be assessed by me, in relation thereto, pursuant to the said Act.

I am,
Your obedient Servant,

………………………………………
Deputy Commissioner.

To the Administrator
of the Estate of

………………………………………

(L.)

“THE STAMP ACT, 1875.”

FORM OF STATEMENT by Administrator of the Real and Personal Property to which the Administration relates to be filed with the Commissioner or Deputy Commissioner within six months from the grant of such Administration, in order to ascertain the amount of duty payable on such Property pursuant to the said Act.

NOTE.—“Administrator” means and includes Executor, Administrator, and also any person succeeding to any property where no probate or letters of administration are required to be issued.

Register. No. 18. Folio

STATEMENT of all Real and Personal Property of or to which , late of , in the , who died on the day of 18 , was possessed or entitled at the time of his death, filed by , of , the Administrator of the Estate and Effects of the Deceased.

PERSONAL PROPERTY.

Inventories, Valuations, and Vouchers must be annexed hereto

Schedules giving detailed particulars must be annexed.

{Cash at Bank and in the House
Furniture, Goods, Chattels, and Effects
Plate, Jewels, and Ornaments
Wines, Spirits, and Liquors
Horses, Carriages, Farming Stock and Implements
Stock in Trade…
Good-will of Trade or Business
Leaseholds giving term, clear annual rent, and terms of renewal
Life Assurance Policies
Rents due at death of deceased
Mortgages, Bonds, Bills, &c., and Interest due at death
Scrip Stock Shares of or in Banks, Companies, Ships, Societies, &c.
All other Personal Property not comprised in above
By amounts of Debts due by deceased and payable thereout

Net Balance of Personal Property

£ s. d. £ s. d.

Money received and Property converted into Money. Value of Property not converted into Money.

Where there is no “life interest or annuity” strike out words “or on account of.”

REAL PROPERTY.

Description :

Brief particulars as to situation and extent must be given here or by schedule.

The dates of deeds and names of parties must be given.

Particulars of all Mortgages and Debts due thereon and the amounts thereof:

Total

Net balance (after deducting such debts) … £
Balance of personal property brought forward… £

Deduct any portion not liable to duty or for which duty is paid on form M … … £

Total net balance on which duty is to be assessed … … … … … £

DECLARATION.

, of , in the New Zealand (severally) make oath and say as follows :—

1. , the Administrator of the Estate and effects of the said deceased.
2. That to the best of knowledge and belief the above statement is true in every particular, and that the Estate and effects of the said deceased do not exceed sterling.

Sworn by the said this day of one thousand eight hundred and
Before me—

ASSESSMENT.

The duty on the within-mentioned sum of £ is assessed at the sum of as per schedule annexed (credit will be given for the sum of £ until life interest or annuity ceases.)

For the Commissioner of Stamps.

RECEIPT.

Stamp Office, 18.

Received from the sum of for [or on account of] the duty assessed as above

For the Commissioner.

Registered.

RECEIPT FOR BALANCE OF DUTY ON DETERMINATION OF LIFE INTEREST OR ANNUITY.

Stamp Office, 18.

Received from the sum of (for which credit was given above), being the balance of the duty assessed as above mentioned.

£ : :

Registered.

For the Commissioner.

• “Administration” includes probates, letters of administration, and any rule or order of Court entitling any person to administer the property of a deceased person.

† Under section 4 of the said Act, “Property” means and includes real and personal property.