Jan. 7.] THE NEW ZEALAND GAZETTE. 7

under the name of " The [Wellington Bootmakers'] Indus-
trial Union of [Workmen]" [or " The (Bootmakers') Indus-
trial Association of (Workmen)]."
We enclose herewith—
(a.) A list of the members and officers of the society [or
a list of the members and officers of the Coun-
cil (or other body) and of the Industrial Unions of
Workmen represented by it].
(b.) Two copies of the rules of the society [or Council, or
other body].
(c.) A copy of a resolution passed by a majority of the
members present at a general meeting of the
society [or Council, or other body] specially called
in accordance with the rules for that purpose
only, and desiring registration as an industrial
union [or association].

Dated at , this day of , 189 .
A.B.,
[Name of office] of the said society [or Council].
C.D.,
[Name of office] of the said society [or Council].
To the Registrar of Friendly Societies.
——
Form 2 (Reg. 2).
No.
NEW ZEALAND.
Under " The Industrial Conciliation and Arbitration Act,
1894."

CERTIFICATE OF REGISTRATION AND INCORPORATION.
THIS is to certify that on the day of 189 ,
the [Wellington Bootmakers'] Industrial Union of [Work-
men] [or the (Bootmakers') Industrial Association of
(Workmen)], , was duly registered and incorporated as
an industrial union [or association] under the provisions of
" The Industrial Conciliation and Arbitration Act, 1894."
Dated at , this day of , 189 .
, Registrar of Friendly Societies.
——
Form 3 (Reg. 6).
Under " The Industrial Conciliation and Arbitration Act,
1894."

DECLARATION AS TO HALF-YEARLY LIST.
I [Full name], of [Address and occupation], do solemnly
and sincerely declare as follows :—
(1.) That I am the President [or Chairman] of the [Full
name of association or union].
(2.) That the list hereto annexed and marked " A " is a
full and correct list of the industrial unions constituting
such association [or of the members of such union], as on
the first day of January [or July], 189 :
And I make this solemn declaration conscientiously be-
lieving the same to be true, and by virtue of the provisions of
" The Justices of the Peace Act, 1882."
(Signed)
Declared at [Name of town] by the said , this
day of , 189 , before me—
A Justice of the Peace in and for the Colony of New
Zealand [or a solicitor of the Supreme Court of New
Zealand].

NOTE.—The list must be marked ' A,' and bear a memo-
randum of identification, thus :—
" This is the list marked ' A ' referred to in the annexed
declaration of , made this day of
189 , before me—
Solicitor [or J.P.]."
——
Form 4 (Reg. 8).
Under " The Industrial Conciliation and Arbitration Act,
1894."

To the Registrar at [Dunedin] of the Supreme Court of
New Zealand, [Otago and Southland] District.
TAKE notice that I [we], the undersigned, hereby signify my
[our] concurrence in an industrial agreement dated the
day of , 189 , made between , and
filed at your office as No. .
Dated this day of , 189 .
A.B.,
[Add occupation and address.]
C.D.,
[Add occupation and address.]
——
Form 5 (Reg. 10).
Under " The Industrial Conciliation and Arbitration Act,
1894."

NOMINATION PAPER FOR ELECTION OF MEMBER OF BOARD
OF CONCILIATION.
A.B., of , [Add occupation and address], is hereby
nominated for election as member of the Board of Concilia-
tion for the [Wellington] Industrial District by the Industrial
Union undersigned.
Dated at [Wellington], this day of , 189 .
For the [Wellington Bootmakers'] Industrial
Union of [Workmen],
C.D., Chairman.
[Or otherwise, as the rules of the Union may prescribe.]
——
Form 6 (Reg. 10).
CONSENT.
I, A.B., of , [Add occupation and address], hereby
consent to be nominated for election as member of the Board
of Conciliation for the [Wellington] Industrial District, by
the [Wellington Bootmakers'] Industrial Union of [Work-
men].
Dated at Wellington, this day of , 189 .
A.B.
——
Form 7 (Reg. 10).
Under " The Industrial Conciliation and Arbitration Act,
1894."

VOTING-PAPER.
THE [Woollen Manufacturers'] Industrial Union of [Em-
ployers], having two votes, hereby votes as follows for the
election of members of the Board of Conciliation for the
[Northern] Industrial District.

Candidate. Votes given.
A.B. :: :: :: :: 1
C.D. :: :: :: :: 1
Total .. .. 2

Dated this day of , 189 .
For the [Woollen Manufacturers'] Industrial
Union of [Employers],
E.F., Chairman.
[Or otherwise, as the rules of the Union may prescribe.]
——
Form 8 (Reg. 16).
Under " The Industrial Conciliation and Arbitration Act,
1894."

APPLICATION THAT INDUSTRIAL DISPUTE BE REFERRED TO
THE CONCILIATION BOARD FOR SETTLEMENT.
(1.) Parties to the industrial dispute : [John White, of Wel-
ington, Boot-manufacturer] and the [Wellington Bootmakers'
Industrial Union of Workmen].
(2.) Date and registered number of industrial agreement
(if any) pursuant to which this application is made : [Date
and Number].
(3.) Particulars of dispute : [State shortly, as thus:—
" On the 1st January, 1895, the employer reduced the wages
of William Black, a member of this Union, by two shillings a
week, and the Union objected to such reduction."]
The parties having failed to satisfactorily adjust the
dispute, application is hereby made to the Clerk of Awards
for the [Wellington] Industrial District that such dispute be
referred to the Conciliation Board for settlement.
Dated at [Wellington], this day of , 189 .
For the [Wellington Bootmakers' Industrial
Union of Workmen],
A.B., Chairman.
[Or otherwise, as the rules of the Union may prescribe.]
To the Clerk of Awards for the above district, and to
[John White], the other party to the dispute.
——
Form 9 (Reg. 19).
HEADING OF DOCUMENTS.
No. .

BEFORE the Board of Conciliation [or the Court of Arbitra-
tion, as the case may be].
In the [Northern] Industrial District.
In the matter of an industrial dispute between A.B. and
C.D., and of a Reference thereof for settlement.
——
Form 10 (Reg. 20).
(Title, as in Form 9.)
I HEREBY convene a meeting of the Board of Conciliation, to
be held at , on the day of , 189 , at
o'clock in the noon, for the purpose of inquiring into
and investigating this dispute.
Dated at , this day of , 189 .
Clerk of Awards.