1418

THE NEW ZEALAND GAZETTE.

[No. 91

tion of the administrator as per form at the foot of
Form L, and by that of such other person as the
Commissioner may require.

The form of certificate upon the statement L,
required by section 6 of the said Act, shall be that
at foot of Form L, and shall be signed by the person
holding the office for the time being of Secretary for
Stamps.

Where the administrator gives security by bond
under section 10 in order to entitle him to receive
the administration, such bond shall be in the form
marked P.

Upon the registration of a settlement under section
23, the particulars of the same shall be entered by
the Deputy-Commissioner in a book to be called the
Record of Settlements.

The statement, to be filed within six months after
the death of the settlor, of a settlement under section
25 of the said Act, shall be in the form marked
M, and shall be verified by the solemn declaration of
the trustee and such other person as the Commissioner
may require.

The amendment of any statement required under
section 31 shall be made in the form marked N, and
shall be verified by the administrator and by such
other person as the Commissioner may require.

F. P. MURRAY,
Acting Clerk of the Executive Council.

(L.)

"THE DECEASED PERSONS' ESTATES DUTIES ACT, 1881."

FORM of STATEMENT by Administrator, to be filed with the
Commissioner or Deputy-Commissioner within six months from
the grant of administration, pursuant to section 5 of the said
Act.

Register No. 188 Folio .

STATEMENT of all Real and Personal Property of or to which
, late of , who died on the day of
188 , was possessed or entitled at the time of his
death, filed by , of , the Administrator of such
property, acting under , dated the day of
188 .

REAL PROPERTY.

Situation and extent of real property, with particulars £ s. d.
of buildings ... ... ... ... ... ... ... ... ...
Deduct amount of mortgages due thereon... ... ... ... ... ... ...

Total ... ... ... ... ... ... ... ... ...

Net balance of real property ... ... ... ... ... ... ...

Net total ... ... ... ... ... ... ... ... ...

Value of property absolutely left to the widow of
deceased ... ... ... ... ... ... ... ... ...

Particulars of life interest or annuities left to the
widow of deceased ... ... ... ... ... ... ... ... ...

Particulars of property, property, or interests in property, left
to the children of deceased ... ... ... ... ... ... ... ... ...

DECLARATION.

, of, in the New Zealand,
[severally], solemnly declare as follows:--

1. , the administrator of the real and personal
   estate of the said , deceased.

2. That, to the best of knowledge and belief, the above
   statement and all inventories and schedules annexed thereto
   are true in every particular, and comprise the whole of the
   real and personal estate of or to which the said deceased was
   possessed, seized, or entitled at the time of his death, which
   did not at that time exceed the value of sterling, and
   that the valuations of such property are the just and true sele-
   able values thereof at that date.

Declared by the said , this day of
one thousand eight hundred and eighty- }
, before me,

CERTIFICATE.

I CERTIFY that the final balance of the real and personal estate
of the deceased comprised in the foregoing statement is £
Secretary for Stamps.

PERSONAL PROPERTY.

Furniture, goods, chattels, and
effects | |
Inventories and valua-Plate, jewels, and ornaments ... ... ... | |
tions must be annexed. 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 re-
newal | |
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, so-
cieties, &c. ... ... ... | |
All other personal property not
comprised in above ... ... ... | |
Deduct amount of debts due by
deceased and payable thereout | |
Net balance of personal pro-
perty ... ... ... £ | |

Schedules giving
detailed particulars
must be annexed.

ASSESSMENT. £ s. d.

Net value of estate, as per certificate ... ... ... ... ... ... ...

Less amount to widow absolutely, under section 5 or
section 40 ... ... ... ... ... ... ... ... ...

Amount dutiable, as per schedule hereunder ... ... ... ... ... ... ... £ s. d.

Less proportion of duty to be allowed under section
37 to the children or grandchildren in respect of
their share of the estate ... ... ... ... ... ... ...

Amount of duty due ... ... ... ... ... ... ... £

Deputy-Commissioner.

RECEIPT.
Stamp Office, , 188
RECEIVED from the sum of for the duty
assessed as above.
Deputy-Commissioner,