✨ Tax Assessment Forms
MAY 12.] THE NEW ZEALAND GAZETTE. 653
issued by the Company in respect of money borrowed
on debentures by the company: £ .
I, , being the duly appointed public officer of the
above-named company, and in that capacity duly authorised
to make the above return, do solemnly and sincerely declare
that I am well acquainted with the affairs of the said com-
pany, and that the said return contains a true and accurate
statement of the income for the year ending the 31st March,
18 , of the debenture-holders in respect of money lent to
the said company on debentures.
Dated this day of , 18 .
(Usual signature:)
Deduction claimed on Account of Liability to pay Land-tax
in respect of Land occupied for Business or Employment,
such Deduction being equal to 5 per Cent. on the Amount
upon which the Company is liable to pay Land-tax on
such Land.
| Assessment No. | Description of Land used as Place of Business or Employment. | Actual Value. | Value of Improvements. | Amount of Mortgage. | Amount on which Land-tax payable. |
|---|---|---|---|---|---|
N.B.—No deduction can be claimed by the owner in respect of
premises or portion of premises let to a tenant.
STATEMENT to be made by Government Departments, Local
Authorities, Persons, Firms, Companies, and Societies
employing Officers, Managers, Travellers, Clerks, Fore-
men, Workmen, Servants, and Others in New Zealand,
whether paid by Salary, Weekly Wage, or otherwise.
List of Persons in the Service or Employ of the Company.
| Name in full. | In what Capacity employed. | Place of Residence. | Amount of Pay received, including Salary, Wages, Bonus, Commissions, and Allowances. |
|---|---|---|---|
NOTE.—In the case of any person the total payment to whom
does not exceed £160 a year, an entry need not be made.
List of Directors, Auditors, and Others to whom Payment
has been made, and who are not included in the above
List.
| Name in full. | In what Capacity employed. | Address. | Amount of Fees, Salary, Bonus, &c. |
|---|---|---|---|
NOTE.—If there should not be sufficient space in any of the above
forms, a sheet giving the required information may be attached.
ALEX. WILLIS,
Clerk of the Executive Council.
By Authority : SAMUEL COSTALL, Govt. Printer for the time being,
Wellington.
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💰
Tax Assessment Form for Debenture Holders
(continued from previous page)
💰 Finance & RevenueTax Assessment, Debenture Holders, Income, Return
💰 Deduction Claim for Land Tax
💰 Finance & RevenueLand Tax, Deduction, Assessment, Business Premises
💰 Employment and Payment Statement
💰 Finance & RevenueEmployment, Payment, Salary, Wages, Bonuses, Commissions
- ALEX. WILLIS, Clerk of the Executive Council
NZ Gazette 1893, No 39