Dec. 19. THE NEW ZEALAND GAZETTE. 2417

Form B.

"The Factories Act, 1901," Section 11.

FORM OF NOTICE TO BE SERVED ON INSPECTOR.

To the Inspector of Factories.

I [or We] hereby give you notice that __ occupy premises No. __ in __ Street as a factory within the meaning of "The Factories Act, 1901," and that __ desire to register such premises as a factory for the purposes of the said Act.

1. Name of factory:
2. Number of rooms, and dimensions:
3. Light, and means of ventilation:
4. Lavatories:
5. Means of escape in case of fire:
6. Yards, closets, urinals, &c.:
7. Nature of work carried on, or to be carried on:
8. Description of motive power (if any):
9. Full name of occupier or intended occupier of factory:
10. Number of persons carrying on business:
11. Maximum number of persons employed or intended to be employed—
    Male:
    Female:
12. Name or style under which the business of the factory is to be carried on:

I [or We] declare these particulars to be correct in every respect.

__, Occupier [or Intended Occupier].

Date: __, 19____.

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Form C.

"The Factories Act, 1901," Section 17.

FORM OF RETURN TO BE MADE BY OCCUPIER OR EMPLOYER.

Town of __
Name of factory: __
Nature of work carried on: __

Number of Persons employed, Age, Sex, Hours of Work, and Earnings.

declare this return to be correct in every particular.

__, Occupier.

Date: __, 19____.

• NOTE.—In counting the number of persons employed in any factory, the occupier, or, if married, such occupier together with husband or wife, as the case may be, shall be considered as one person.

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Form D.

"The Factories Act, 1901," Sections 14, 15, 16.

CERTIFICATE OF REGISTRATION.

This is to certify that the premises occupied by __, known as __, __ Street, __, in which __ persons are employed, have this day been registered under "The Factories Act, 1901," as a factory for the manufacture of __ or preparing for the manufacture of __, and that the registration fee of __ for the year ending 31st March, 19____, has been paid.

__, Inspector,

Date: __, 19____.

Form E.

NOTICE.

"The Factories Act, 1901," Section 17.

Name and address of the Inspector for the district: __
Name and address of the medical authority for such district: __
Official address of local authority: __
Holidays of factory: Christmas Day, New Year’s Day, Good Friday, Easter Monday, Labour Day, and the Sovereign’s Birthday.
Working-hours of factory: __, Occupier of Factory.

NOTE.—"The Factories Act, 1901," section 35, provides as follows:—

35. (1.) Wages for each whole or half holiday shall in the case of each woman or boy under eighteen years of age be at the same rate as for ordinary working-days, and shall be paid at the first regular pay-day thereafter.

(2.) This section shall apply to every woman or boy under eighteen years of age who is paid by time-wages, whatever the time, and has been employed in the factory for at least twenty days during the four weeks next preceding the whole holiday, or for at least five days during the month next preceding the half-holiday, whether such employment has been on consecutive days or not, and whether the person employed has been continuously in the service of the occupier or not.

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Form F.

"The Factories Act, 1901."

RETURN OF OVERTIME TO BE MADE BY OCCUPIER OR EMPLOYER.

Name of place (town, &c.): __
Name of factory: __
Nature of work carried on: __

Persons employed, Hours worked, and Earnings paid on Overtime only.

declare this return to be correct in every particular.

Date: __, 19____.

__, Occupier [or Firm].

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Form G.

"The Factories Act, 1901," Section 27.

I, __, Inspector of Factories, hereby certify that I am satisfied that* __ is of the age of __ years, and fit for employment in the factory of __ in the trade of __, and in all factories in the same line of trade, and also that the said __ has passed the Fourth Standard examination under "The Education Act, 1877," or†

Dated at __, this __ day of __, 19____.

__, Inspector,

Station.

• Full names. † State other equivalent examination.

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Form H.

"The Factories Act, 1901," Section 63.

NOTICE OF APPEAL.

In the matter of "The Factories Act, 1901"; and in the matter of a requisition by __, of __, an Inspector under the said Act, which said requisition is dated the __ day of __, 19, and is numbered __.

Notice is hereby given that I [we], the occupier upon whom the said requisition has been served, consider such requisition to be unreasonable, and desire to appeal therefrom. A true copy of the said requisition is hereto attached, marked "A."

Dated at __, this __ day of __, 19____.

__, Occupier of Factory.