1126
THE NEW ZEALAND GAZETTE.
[No. 49.

And I deposit herewith the sum of £
, being the half-year’s rent and other payments prescribed in respect of the allotment applied for.*

In proof of my fitness and qualifications to hold the land applied for, I hereby make the following replies to the under-mentioned questions:—

2. Are you married? ..
3. What is your trade, business, or occupation, and are you employed thereat; if so, where and by whom?
4. How many children have you living with you, and what are their respective ages?
5. Do you desire the Government to assist you in building, planting, or fencing, by an advance of money? If so, to what extent, and for what purposes?
6. What land do you hold or have an interest in? Give particulars of the block, section, area, and value of such land, and say whether it is freehold, leasehold, or what other tenure, specifying also what portion of it (if any) is rural and what portion (if any) is town or suburban land.
7. What land does your wife (or husband) hold or have an interest in? Give particulars as above.
8. Is the rural land (if any) mentioned in answers 6 and 7 insufficient for the maintenance of yourself and your family? If so, give your reasons.
9. Is the town or suburban land (if any) mentioned in answers 6 and 7 insufficient for a home for yourself and your family? If so, give your reasons. | |

Declaration.

I,
, of
, do solemnly and sincerely declare,—

1. That I am of the age of twenty-one years and upwards.

2. That I am the person who, subject to the provisions of “The Land for Settlements Act, 1894,” “The Land for Settlements Act Amendment Act, 1896,” and the regulations made thereunder, am applying for a lease in perpetuity of one of the allotments described in the foregoing application.

3. That I am acquiring such lease solely for my own use and benefit, and not directly or indirectly for the use or benefit of any other person or persons whomsoever.

4. That I am not, directly or indirectly, either by myself or jointly with any other person or persons, the tenant or occupier of any land whatsoever under “The Land Act, 1892,” or “The Land for Settlements Act, 1894,” or their respective amendments, nor the owner in fee-simple, nor the tenant or occupier under a lease for a term whereof not less than two years are unexpired, of any other land in the colony which, being town or suburban land, exceeds one-fourth of an acre, or, being rural land, exceeds 50 acres, in area, or which exceeds in value £300.

5. That the total value of all the freehold and leasehold property owned by me does not (after deducting the encumbrances thereon) exceed £300.

6. That my answers to the foregoing questions (Nos. 1 to 9) are true and correct in every particular.

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 in full.]

• If more than one allotment is applied for, the deposit should be for the allotment requiring the largest deposit.

Declared at
, this
day of
, one thousand
, before me—
[Signature],
A Justice of the Peace in and for the Colony of New Zealand [or as the case may be].

Received on
, at
, Commissioner of Crown Lands.

SECOND SCHEDULE.
(New Zealand.)

LEASE IN PERPETUITY of Land in the Tamai Hamlet, under “The Land Act, 1892,” and “The Land for Settlements Act, 1894,” and the Amendments thereof.

THIS DEED, made the
day of
, one thousand
, between Her Majesty the Queen (who, with her heirs and successors, is hereinafter referred to as “the lessor”), of the one part, and [Full name], of [Residence], in the Colony of New Zealand [Occupation] (who, with his executors, administrators, and permitted assigns, is hereinafter referred to as “the lessee”), of the other part.

Whereas the allotment of land described in the First Schedule hereto has been acquired by the lessor under “The Land for Settlements Act, 1894”: And whereas, pursuant to the provisions of that Act and the regulations in that behalf, the lessee duly applied for a lease in perpetuity of the said allotment as a workman’s home, and on the
day of
, one thousand
, his application was duly declared to be successful by the Land Board of the Canterbury Land District (hereinafter called the “Land Board”):

Now this deed witnesseth that, in consideration of the rent hereinafter reserved, and of the covenants, conditions, and agreements herein contained and implied, and on the part of the lessee to be paid, observed, and performed, the lessor doth hereby demise and lease unto the lessee all that piece of land, containing by admeasurement
acres
roods
perches, a little more or less, situated in the Land District of Canterbury aforesaid, and being allotment numbered
of the Tamai Hamlet, as the same is more particularly described in the First Schedule hereto, and delineated in the plan drawn thereon, it being therein coloured red in outline; together with the rights, easements, and appurtenances to the same belonging: To hold the said several premises intended to be hereby demised unto the lessee for the term of nine hundred and ninety-nine years, to be reckoned from the first day of
, one thousand
, and including, in addition, the broken period between the date of this lease and such day. Yielding and paying therefor during the said term unto the Receiver of Land Revenue for the said Land District of Canterbury, free from all deductions whatsoever, the clear annual rent of
, computed from the said first day of
, one thousand
, and payable in manner following, that is to say:—

(a.) By a payment of
before the execution of these presents, such payment (which has been duly made) being in respect of rent in advance for the first half-year, computed as aforesaid; and also

(b.) By the payment thereafter of
half-yearly in advance on the 1st day of January and 1st day of July in each and every year during the said term, the first of such payments to become due and to be made on the 1st day of
, one thousand
.

And the lessee doth hereby covenant with the lessor as follows, that is to say:—

1. Subject to the provisions of “The Land Act, 1892,” as to relaxing or dispensing with the conditions relating to residence, the lessee will reside on the demised land within one year from the date of this lease, and thereafter such residence shall be continuous for the period of ten years.

2. The lessee will put on the demised land substantial improvements of a permanent character to the satisfaction of the Commissioner of Crown Lands for the Canterbury Land District (hereinafter called “the Commissioner”), as under:—

(a.) Within one year from the date of this lease, a substantial dwellinghouse to the value of at least £30;

(b.) Within two years from the date of this lease, a sufficient fence, within the meaning of “The Fencing Act, 1895,” round the land, with gates complete;

(c.) Within three years from the date of this lease, at least one-fourth of the area of the demised land shall be fenced off, and be under proper cultivation as a garden or orchard.

3. The lessee will once a year throughout the said term, and at the proper season of the year, properly cut and trim all live fences now on the demised land, or which may be