JUNE 28.] THE NEW ZEALAND GAZETTE. 1205

Form 86 (Reg. 28).

APPLICATION TO SURRENDER MINING PRIVILEGES FOR PURPOSES OF EXCHANGE FOR TITLE UNDER “THE MINING ACT, 1898.”

To the Warden of the Mining District, at

PURSUANT to “The Mining Act, 1898,” the undersigned [Full name, occupation, and residence], being the holder of the mining privileges specified in the Schedule hereto, hereby applies to surrender the same, and to obtain in substitution therefor licenses for corresponding mining privileges under that Act.

The address for service is:

Dated this day of , 1 .

THE SCHEDULE ABOVE REFERRED TO.

[Signature of applicant, &c.]

Precise time, &c.

——

Form 87 (Reg. 28).

Under “The Mining Act, 1898.”

APPLICATION FOR AMALGAMATION OF CLAIMS.

To the Warden of the Mining District, at

PURSUANT to “The Mining Act, 1898,” the undersigned [Full name, occupation, and residence], being the holder of the claims described in the Schedule hereto, and being desirous of facilitating the working thereof, and simplifying the titles thereto, hereby applies for the amalgamation thereof into one claim.

The address for service is:

Dated this day of , 1 .

THE SCHEDULE ABOVE REFERRED TO.

[Signature of applicant, &c.]

Precise time, &c.

——

Form 88 (Reg. 28).

APPLICATION FOR CERTIFICATE OF PROTECTION.

To the Warden of the Mining District, at

PURSUANT to “The Mining Act, 1898,” the undersigned [Full name, occupation, and residence], hereby applies for a protection certificate for the period of in respect of the mining privileges particulars whereof are set out in the Schedule hereto.

The address for service is:

Dated at , this day of , 1 .

THE SCHEDULE ABOVE REFERRED TO.

[Signature of applicant, &c.]

Precise time, &c.

Form 89 (Reg. 28).

Under “The Mining Act, 1898.”

LICENSE FOR EXTENDED [or SPECIAL] CLAIM.

LICENSE FOR [Set out class and subdivision of claim—e.g. SPECIAL DREDGING CLAIM, EXTENDED QUARTZ CLAIM, or otherwise, as the case may be].

PURSUANT to the provisions of “The Mining Act, 1898,” I, the undersigned, , Warden of the Mining District, do hereby grant to [Full name, occupation, and residence], this license for [Set out class and subdivision of claim as above], in respect of the land described in the First Schedule hereto, for a term commencing on the date hereof, and expiring on the 31st day of December, 1 , subject to the payment of the rent as specified in the Second Schedule hereto, and also to the reservations, terms, conditions, and provisions set out in the said Act or the regulations thereunder, and to such additional reservations, terms, conditions, and provisions as are specified by the Warden in the Third Schedule hereto.

In witness whereof I have hereunto subscribed my name, and affixed the seal of the Warden’s Court at , this day of , 1 .

THE FIRST SCHEDULE ABOVE REFERRED TO.

All that area of land in the Mining District, containing by admeasurement acres roods and perches, situate [Here set out section, block and survey district, and plan, if land is surveyed; or, if unsurveyed, its situation, boundaries, and measurements].

THE SECOND SCHEDULE ABOVE REFERRED TO.

(1.) A rental in respect of each acre or portion thereof at the rate of 2s. 6d. for the first, 5s. for the second, and 7s. 6d. for each subsequent year of the term, the amount of the rental being, for the first year , for the second year , and for each subsequent year .

(2.) All payments in respect of the aforesaid rent have been duly made up to the last day of June [or December] next following the date of this license, and the subsequent payments are to be made by half-yearly instalments in advance, the first half-yearly instalment being due and payable in advance on the last day of June [or December] aforesaid.

THE THIRD SCHEDULE ABOVE REFERRED TO.

[Set out additional reservations, &c., if any.]

, Warden.

——

Form 90 (Reg. 28).

Under “The Mining Act, 1898.”

LICENSE FOR AN ORDINARY CLAIM.

[As in Form No. 89, omitting all references to rent or to the expiry of the term, and specifying the number of years of the term, and making all other necessary modifications.]

——

Form 91 (Reg. 28).

Under “The Mining Act, 1898.”

LICENSE FOR MINING PRIVILEGE IN RESPECT OF WATER.

1. Mining privilege for which this license is granted: e.g., Water-race, with right to divert sluice-heads out of a watercourse commonly known as for purposes of [Set out purposes], [or Tail-race, Main tail-race, Dam, Drainage-area, or otherwise, as the case may be].

2. Description of the mining privilege, and of the land on which it is to be constructed, maintained, or used: As set forth in the First Schedule hereto.

3. Name, occupation, and residence of licensee:

4. Term of the license: A term of years, commencing on the date hereof.

5. Terms, conditions, reservations, and provisions subject to which the license is granted: Those of “The Mining Act, 1898,” and the regulations thereunder, and also those set forth in the Second Schedule hereto.

Pursuant to the provisions of “The Mining Act, 1898,” I, the undersigned , Warden of the Mining District, do hereby grant to the above-named licensee this license for the [water-race or otherwise], as specified herein, subject as herein mentioned.

In witness whereof I have hereto subscribed my name, and affixed the seal of the Warden’s Court at , this day of , 1 .

THE FIRST SCHEDULE ABOVE REFERRED TO.

Description of the mining privilege and of the land: [Describe land and nature of the proposed work as set forth in application, modified, however, so as to accord with the grant, adding such other particulars as are necessary, including plan of land if surveyed].

THE SECOND SCHEDULE ABOVE REFERRED TO.

[Set out additional reservation, &c., if any.]

, Warden.