1448
THE NEW ZEALAND GAZETTE.
[No. 86

“I am not aware of any mortgage, charge, encumbrance, or claim affecting the land above described, or any part thereof, or my estate or interest therein, or that any person hath any claim, estate, or interest in the said land at law or in equity, in possession or expectancy, adverse to my application, title, estate, or interest.

“There is no person in possession or occupation of the said land above described adversely to my estate or interest therein, and that the said land is now in my occupation, and that there are no deeds, instruments, or evidences of title affecting such land in my possession, or under my control, other than those enumerated in the First Part of the Schedule hereto. I believe that the deeds, instruments, and evidences of title set forth in the Second Part of the said Schedule are in the possession or control of the persons named in the said Second Part of the said Schedule.

“My title to make this application arises as follows [Here set out full particulars of title, whether the applicant is an original lessee or assignee or otherwise, and whether he is applying for the whole or part of the land comprised in a lease]:—

“And I make this solemn declaration, conscientiously believing the same to be true, and by virtue of the provisions of an Act of the General Assembly of New Zealand intituled ‘The Justices of the Peace Act, 1882.’

“Declared at
, this
day of
, 1892,
before me,

“A Justice of the Peace in and for the Colony of New Zealand.”

——

“Schedule referred to in the above Declaration.

“First Part: [Here set out with particularity the deeds, instruments, and evidences of title in the possession or control of the applicant.]

“Second Part: [Here set out with particularity the deeds, instruments, and evidences of title not in the possession or control of the applicant, but which do affect his title, and state where they are to be found.]

“I,
, the above declarant, apply for a new lease of the land described in the above declaration under section eight of ‘The West Coast Settlement Reserves Act, 1892;’ and I hereby agree with the Public Trustee to be bound by all the provisions of the said ‘West Coast Settlement Reserves Act, 1892,’ and all regulations made thereunder, relating to the granting of new leases under section eight of the said Act, and to surrender any lease or tenancy under which I now hold reserves or any part thereof, and to accept a new lease of the said land under section eight of the said Act for the term, at the rent, and under and subject to the covenants, agreements, provisions, and conditions provided or authorised by ‘The West Coast Settlement Reserves Act, 1892,’ and regulations made thereunder, and to execute the said lease in triplicate, and to pay the costs of the preparation, execution, stamping, registration, and completion of such lease in triplicate and of and incidental thereto.

“My address is [Here insert name, occupation, and residence].

“Dated this
day of
, 189
.

“Witness: A.B.”
Applicant.

[Residence and occupation.]

3. The application shall be lodged at the Public Trust Office, Wellington. An indorsement shall be made on the application of the date upon which it was lodged. If the leasehold estate or interest of any applicant in the land comprised in the application shall be subject to any mortgage, charge, encumbrance, or claim, then the declaration hereinbefore referred to shall be altered so as to state the nature thereof, and the holder of the mortgage, charge, or encumbrance must consent to the application in writing, and before the new lease is granted such holder must release his mortgage, charge, or encumbrance.

4. The declaration shall state whether the applicant is an original lessee or an assignee, and shall state the date of the original leases, the parties thereto, and the registered numbers thereof, whether in the Land Transfer Office or the Deeds Registry. If the applicant is an assignee, then, in addition to the foregoing, the declaration shall state the nature of the instruments or evidences of title under which the assignee derives title, with the respective dates thereof, the parties thereto, and the registered numbers thereof respectively. If an award under the provisions of subsection (d) of subsection (1) of section eight of the said Act forms part of the applicant’s title, the date of the award and reasonably full particulars thereof, and of the assignments, shall be stated in the declaration.

5. At the time of the lodging of the application the applicant shall lodge therewith all deeds, instruments, and other evidences of or affecting his title to the lands comprised in the application in the applicant’s possession or under his control, and shall state, so far as he knows, where any other deeds, instruments, or evidences relating to his title and not in his possession or control are.

6. At the time of the lodging of the application the applicant shall deposit with the Public Trustee the sum of £12 10s. for the purpose of covering the costs of advertisements, valuations, the preparation, execution, stamping, registration, and completion of the surrender of any existing lease and of the new lease and incidental