794

SCHEDULE OF DUTIES.

In respect of all Personal Property left after the payment of all debts payable thereout, and in respect of the Value of all Real
Property left after deducting the amount of all mortgages and other debts secured thereon :-

Exemptions.-1. So much of such property as descends to the husband or wife of the deceased.
2. Any property held by the deceased as a trustee, and in which he has no beneficial interest.
3. Any property devised or bequeathed to or in trust for any corporation or body of persons appointed for religious,
charitable, or educational purposes.

(M.
"THE STAMP ACT, 1875."
This form, when used, is STATEMENT of the Value of Life Interest
to be attached to state- in Property or of Annuity, or Annual
ment form L. Sum of Money for Life.
Register No. 18 Folio

State whether life interest
in freehold or annuity.
STATEMENT of
queathed to
died on the
by
day of
given or be-
who
18
State whether rent of and charged on or payable out of
freehold, or payable out
of any and what fund.
as under.

PARTICULARS OF LIVE INTEREST OR ANNUITY.

THE NEW ZEALAND GAZETTE.

declare that this is a just and true statement of the life
interest or annuity to which is entitled to succeed
beneficially for life, upon the death of the before-named
and that I am informed and verily believe the said
was born on the day of 18 , and is a
of the said from whom the same is derived.
Dated at this day of , 18
(Here sign the Account).

ASSESSMENT.
THE value of a life interest or annuity of £ for a life
aged is £ and the Duty on this sum, at the
rate of per cent., is assessed at £

For the Commissioner of Stamps.

RECEIVED from
above mentioned.
£ Registered,

RECEIPT FOR DUTY.
Stamp Office, , 18
the sum of , being the full duty

For the Commissioner.

(Ν.)
"THE STAMP ACT, 1875."
Register No. 18 Folio

To be used where too AMENDED STATEMENT, under Section 117 of
little duty has been the said Act, of all Real and Personal Property
paid, of or to which , late of , was
, who died on the day of 18
possessed or entitled at the time of his death (and the value
thereof), exhibited by , as the Administrator of the
estate and effects of the Deceased.

| Items omitted in former statement must be set out in detail, and accompanied by vouchers. | | £ s. d. |
|---|---|---|---|---|---|
| Particulars, as in Statement L., must be given in all cases. | L. brought down Amended statement Personal Property | |
| | Deduct amount of additional debts due by deceased, and payable thereout | |
| | Amended statement-Real Property | |
| | Deduct additional Mortgages, &c., due by deceased | |
| | Net balance, after deducting debts | |
| | Deduct any part not liable to duty | |
| | Total net balance | |

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 the estate and
   effects of the said deceased do not exceed the value of
   sterling.
   Sworn by the said , this day of , one
   thousand eight hundred Before me-

ASSESSMENT.
Supply Schedule, THE duty on the above sum of £ is
showing how total assessed at the sum of £ , as per
duty is made up. Schedule annexed, credit being allowed for the
sum of £ , paid as per receipt on Statement L.

For the Commissioner of Stamps.