MAY 16.] THE NEW ZEALAND GAZETTE. 653

Any person having any objection to this application must
lodge the same in writing at the Warden's office at
within seven days from the date hereof.

[Date.]

Warden.

SCHEDULE 36 (Sec. 127 Act).
CERTIFICATE OF AUTHORITY TO CONVEY OR DISCHARGE
DÉBRIS ON, TO, OR OVER GROUND.

No.

I HEREBY certify that has received authority to dis-
charge débris upon [or to convey débris over]
and
to occupy thereon sufficient space for the discharge of such
débris. [State conditions, if any.]

Dated at , this day of , 18.
Warden.

SCHEDULE 37 (Reg. 243).

No. ___

MEMORIAL FOR REGISTRATION OF CLAIM OR RIGHT TO BE
PRESENTED IN DUPLICATE TO THE REGISTRAR, WHO
SHALL SIGN AND RETURN ONE COPY THEREOF.

Locality. | Names of Owners | Names of Claim | State Day and | Distinguishing | Give Name, | Remarks.
| and interests | or Right. | Hour of mark- | Marks on Posts. | Situation,
| held by them | | ing out. | | and Area of
| respectively. | | | | Claim or Right,
| | | | | as per survey
| | | | | plan.

[Signature of person applying for registration.]

Registered
Dated at , the day of , 18.

[No. and date of miner's right].
Registrar.

SCHEDULE 38 (Reg. 245).
MEMORANDUM OF ASSIGNMENT.

No. ___, Part I.
Assignment or Transfer—

Date of Registration:

Particulars—
Name in full, address, and
occupation of Assignor:
Name in full, address, and
occupation of Assignee:
Date of assignment:
Nature of property assigned:
Interest therein assigned:
Reference to folio of register:
Fees received:

[Signature of Assignee,}
or Agent presenting}
Assignment.]

No. , Part II.
Memo. of Assignment.
Mining Registrar's Office,
18.

I have this day registered a
document exhibited to me by
, purporting to be an
assignment of , of which
the particulars are as follows:
Name of assignor:
Name of assignee:
Date of assignment:
Amount of consideration:
Nature of property assigned:
Interest assigned therein:
Reference to folio of register:
Fees received:

Mining Registrar.

Original documents to be retained and filed on record.

12

SCHEDULE 39 (Reg. 249).
MEMORIAL OF ENCUMBRANCE.

To be presented in duplicate, and one copy signed and
returned by Registrar.

No. ___

Name of Claim, | Interest | Name of | Nature of | Date | Amount of | Remarks.
or Registd. | intended to | Owner of | Encum- | of Instru- | Encum-
No. of | be affected | Interest. | brance. | ment. | brance.
Certificate. | by such |
| Encumbrance. |

[Date of memorial.]
[Signature of grantor of encumbrance.]
[Signature of grantee of encumbrance.]

Registered
[Signature of Registrar.]
[Date.]

SCHEDULE 40 (Reg. 249).
DISCHARGE OF ENCUMBRANCE.

No. ___

To the Mining Registrar,
Take notice that Encumbrance No. , upon the interest
of in the claim, has been satisfied and dis-
charged this day of , 18.
[Signature of grantee of encumbrance.]
[Date of registration.]
Registrar.

SCHEDULE 41 (Reg. 219).
SCALE OF FEES FOR SURVEY.

There shall be paid for the survey of any area as fol-
lows:—

Not exceeding 30 acres, 4s. per acre, but not less than £5.
Exceeding 30 and up to 50 acres, 3s. 6d. per acre, but not
less than £6.
Exceeding 50 and up to 100 acres, 3s. per acre, but not
less than £8 15s.
Exceeding 100 and up to 200 acres, 2s. 6d. per acre, but
not less than £15.
Extended claims £2 10s. each.
Travelling expenses 3s. per mile one way.
Bush-cutting 2s. 6d. per chain.
Underground surveys, encroachments, water-races, or
other surveys to which the foregoing rates do not apply,
shall be paid for as follows:—
Surveyor's fee, £1 10s. per day or part of a day.
Labour extra.
Mileage 3s. per mile one way.

SCHEDULE 42 (Reg. 251).
APPLICATION FOR PERMISSION TO CUT TIMBER.

To the Warden at
I hereby make application for permission to cut
timber on Crown lands within the district of .
Dated at , the day of , 18.
[Signature.]
[Number and Date of Miner's Right.]

Any person having any objection to this application must
lodge the same in writing at the Warden's office at
within seven days from the date hereof.
[Date.]
Warden.

SCHEDULE 43 (Reg. 251).
TIMBER CERTIFICATE.

No. ___

I HEREBY certify that has received permission to cut
timber (except kauri or reserved trees), within the District
of , for the period of twelve months from the date
hereof [subject to all Native rights during the currency of
this certificate.]
Dated at , the day of , 18.
Warden