Mar. 14.] THE NEW ZEALAND GAZETTE. 673

Form 2 (Reg. 2).
No. , New Zealand.
CERTIFICATE OF REGISTRATION AND INCORPORATION.
Under “The Industrial Conciliation and Arbitration Act, 1900.”

This is to certify that on the day of , 19 , the [Wellington Bootmakers’ Society, or as the case may be] was duly registered and incorporated as an industrial [union, or as the case may be] pursuant to “The Industrial Conciliation and Arbitration Act, 1900,” under the style of [The Wellington Bootmakers’ Society, Industrial Union of Workers, or as the case may be].

Dated at , this day of , 19 . Registrar.

Form 3 (Reg. 3).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

APPEAL FROM REFUSAL TO REGISTER AN INDUSTRIAL UNION OR ASSOCIATION.

To the Clerk of Awards at .

Pursuant to the provisions of section 11 of “The Industrial Conciliation and Arbitration Act, 1900,” the Industrial Union [or Association], being dissatisfied with the decision of the Registrar refusing to register the said industrial union [or association], hereby appeals to the Court to make inquiry, on the ground that by [State reason for inquiry] it will be more convenient for the members to register separately than to join an existing union [or association].

Dated at , this day of , 19 .
A. B.,
[Name of office] of the said industrial union [or association].
C. D.,
[Name of office] of the said industrial union [or association].

Form 4 (Reg. 4).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

DECLARATION AS TO YEARLY LIST.

I, [Full name], of [Address and occupation], do solemnly and sincerely declare as follows:—
(1.) That I am the President [or Chairman, or Secretary] 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 whose subscriptions are not more than twelve months in arrear], and of the officers (including trustees) of such association [or union], as on the 1st day of January, 19 .

And I make this solemn declaration conscientiously believing 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 , 19 , 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 memorandum of identification, thus:—
“This is the list marked ‘A’ referred to in the annexed declaration of , made this day of , 19 , before me—
Solicitor [or J.P.].”

Form 5 (Reg. 5).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

APPLICATION FOR REGISTRATION OF BRANCH OFFICE.

Pursuant to the provisions of section 14 of “The Industrial Conciliation and Arbitration Act, 1900,” I hereby make application for the registration under that Act of a branch office of the [Registered name of the industrial union or association], situate at [Describe situation of branch office fully], in the Industrial District.

Dated at , this day of , 19 .
[Seal.]
A. B.,
Chairman [or Secretary].

To the Registrar of Industrial Unions.

Form 6 (Reg. 6).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

APPLICATION FOR CANCELLATION OF REGISTRATION.

Pursuant to the provisions of section 20 of “The Industrial Conciliation and Arbitration Act, 1900,” we hereby make application that the registration of the [Registered name of the industrial union or industrial association] shall be cancelled.

We enclose herewith—
(a.) The certificate of registration;
(b.) A copy of a resolution passed by a majority of the members present at a general meeting of the said industrial union [or association] specially called in accordance with the rules for that purpose only, and desiring that the registration of the said industrial union [or association] be cancelled.

Dated at , this day of , 19 .
[Seal.]
A. B.,
[Name of office] of the said industrial union [or association].
C. D.,
[Name of office] of the said industrial union [or association].

To the Registrar of Industrial Unions.

Form 7 (Reg. 8).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

NOTICE OF CONCURRENCE WITH INDUSTRIAL AGREEMENT.

To the Clerk of Awards at .

Take notice that I [we], the undersigned, hereby signify my [our] concurrence in an industrial agreement dated the day of , 19 , made between , and filed at your office as No. .

Dated at , this day of , 19 .
A. B., &c.

Form 8 (Reg. 10).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

NOMINATION-PAPER FOR ELECTION OF MEMBER OF BOARD OF CONCILIATION.

A. B., of , [Add address and occupation], is hereby nominated for election as member of the Board of Conciliation for the [Wellington] Industrial District by the industrial union undersigned.

Dated at , this day of , 19 .
[Seal of industrial union.]

For the [Wellington Bootmakers’] Industrial Union of [Workers],
C.D., Chairman [or Secretary].
[Or otherwise, as the rules of the Union may prescribe.]

Form 9 (Reg. 10).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

CONSENT.

I, A. B., of , [Add address and occupation], 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 [Workers].

Dated at , this day of , 19 .
A. B.

Form 10 (Reg. 10).
Under “The Industrial Conciliation and Arbitration Act, 1900.”

VOTING-PAPER.

The [Woollen-manufacturers’] Industrial Union of [Employers], 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 at , this day of , 19 .
[Seal of industrial union.]

For the [Woollen-manufacturers’] Industrial Union of [Employers],
E. F., Chairman.
G. H., Secretary.