568
THE NEW ZEALAND GAZETTE.
[No. 30

Survey District.
Block.
Section.
Area.
Price per Acre.
Total Price.
Deposit paid.
Remarks.
A.
R.P.
£
s.d.
£
s.d.

SECOND SCHEDULE.
NEW ZEALAND.
APPLICATION FOR UNSURVEYED RURAL LAND FOR CASH.
To the Commissioner of Crown Lands,
I HEREBY apply to purchase acres roods perches of rural lands, particulars of which are hereunder given, under the provisions of sections 11 to 13 of “The Land Act Amendment Act, 1887.”
(Signature in full.)
(Residence.)
(Occupation.)
Date: , 18 .

FORM OF DECLARATION.
I, , do solemnly and sincerely declare that I am purchasing acres of rural land, as per plan attached, solely for the use and benefit of , who reside in the colony, and for whom I am trustee, and not directly or indirectly for the use or benefit of any other person or persons whomsoever; and that the said is not the holder, either in own name or in the name of any other person, of freehold land, or of land held under the deferred-payment system or the perpetual-lease system, in the Land District of , to an extent which, added to the acreage comprised in this present application, would exceed 640 acres of first-class land and 2,000 acres of second-class land. And I make this solemn declaration conscientiously believing the same to be true, and by virtue of an Act of the General Assembly of New Zealand intituled “The Justices of the Peace Act, 1882.”
(Signature.)
This declaration was made and signed in my presence at , on this day of , 18 , before me, , a Justice of the Peace for the Colony of New Zealand.
Received on , 18 , at Commissioner of Crown Lands.

Survey District.
Block.
Section.
Area.
Price per Acre.
Total Price.
Deposit paid.
Remarks.
A.
R.P.
£
s.d.
£
s.d.

THIRD SCHEDULE.
License No. .
NEW ZEALAND.
APPLICATION FOR UNSURVEYED RURAL LAND ON DEFERRED PAYMENTS.
To the Commissioner of Crown Lands,
I HEREBY apply to select acres roods perches of rural lands, particulars of which are hereunder given.
(Signature in full.)
(Residence.)
(Occupation.)
(Road district.)
(County.)
Date: 18 .

Survey District.
Block.
Section.
Area.
Price per Acre.
Total Price.
Deposit paid.
Remarks.
A.
R.P.
£
s.d.
£
s.d.

FORM OF DECLARATION.
I, , of , do solemnly and sincerely declare as follows:—

1. I am of the age of seventeen years and upwards.
2. I am applying for acres of rural land, as per plan attached, under the system of deferred payments, under “The Land Act, 1885,” and its amendments, bonâ fide for my own exclusive use and benefit, and not directly or indirectly for the use or benefit of any other person whomsoever, and for the purpose of cultivation.
3. I have not at any time acquired the freehold of any land under the deferred-payment system, or under the homestead system, which, with my present application, will exceed 640 acres in all.
4. I am not the holder, either in my own name or in the name of any other person, of, and that I am not beneficially interested in, any lands of the Crown within the colony under the deferred-payment system, or under the perpetual-lease system, or under any agricultural lease, to an amount which, added to the acreage comprised in this present application, would exceed 640 acres in extent.
5. I am not the owner of a pre-emptive right, or of 640 acres of land in all.
   And I make this solemn declaration conscientiously believing the same to be true, and by virtue of an Act of the General Assembly of New Zealand intituled “The Justices of the Peace Act, 1882.”
   (Signature.)
   Taken and declared at , this day of , 18 , before me, , a Justice of the Peace for the Colony of New Zealand.
   Received on , 18 , at Commissioner of Crown Lands.

FOURTH SCHEDULE.
Lease No. .
NEW ZEALAND.
APPLICATION FOR UNSURVEYED RURAL LAND ON PERPETUAL LEASE.
To the Commissioner of Crown Lands,
I HEREBY apply to select acres roods perches of rural lands, particulars of which are hereunder given.
(Signature in full.)
(Residence.)
(Occupation.)
(Road district.)
(County.)
Date: , 18 .

Survey District.
Block.
Section.
Area.
Rent per Acre.
Capital Value per Acre.
Amount deposited.
Remarks.
A.
R.P.
£
s.d.
£
s.d.

FORM OF DECLARATION.
I, , of , do solemnly and sincerely declare as follows:—

1. I am of the age of seventeen years and upwards.
2. I am the person who, subject to the provisions of “The Land Act, 1885,” and its amendments, am applying for the lease of acres of rural land, as per plan attached.
3. I am applying for a perpetual lease of the said land solely for my own use or benefit, and for the purposes of cultivation, and not, directly or indirectly, for the use or benefit of any other person whomsoever.
4. Including the said lands, I am not the owner, tenant, or occupier, directly or indirectly, either by myself or jointly with any other person or persons, of any lands anywhere in the colony exceeding in the whole 640 acres [or, if including second-class lands selected under “The Land Act Amendment Act, 1887,” 2,000 acres].
5. I have not, within three years prior to the date hereof, surrendered a lease granted under “The Land Act, 1885,” or its amendments, with perpetual right of renewal of the lands for a lease whereof I am now applying.
   And I make this solemn declaration conscientiously believing the same to be true, and by virtue of an Act of the General Assembly of New Zealand intituled “The Justices of the Peace Act, 1882.”
   (Signature.)
   Taken and declared at , this day of , 18 , before me, , a Justice of the Peace for the Colony of New Zealand.
   Received on , 18 , at Commissioner of Crown Lands.
   ALEX. WILLIS,
   Clerk of the Executive Council.