674
THE NEW ZEALAND GAZETTE.
[No. 28

Form 11 (Reg. 16).
Under “The Industrial Conciliation and Arbitration Act, 1900.”
APPLICATION FOR CONSTITUTION OF SPECIAL BOARD OF CONCILIATORS.
In the matter of an industrial dispute between A. B. and C. D.
We, the undersigned, being all the parties to the above-named industrial dispute, do hereby apply for the constitution of a Special Board of Conciliators for the purpose of settling such dispute.
Dated at __, this __ day of __, 19____.
[Signatures of all the parties.]
To the Registrar of Industrial Unions.

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Form 12 (Reg. 18).
Under “The Industrial Conciliation and Arbitration Act, 1900.”
APPLICATION THAT INDUSTRIAL DISPUTE BE REFERRED TO THE BOARD OF CONCILIATION FOR SETTLEMENT.
(1.) PARTIES to the industrial dispute: [John White, of Wellington, Boot-manufacturer] and the [Wellington Bootmakers’ Industrial Union of Workers].
(2.) Industrial agreement (if any) pursuant to which this application is made: [State date and parties, and date and place of filing].
(3.) Particulars of dispute: [State shortly, as thus:— “On the 1st January, 1901, 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 Board of Conciliation for settlement.
Dated at __, this __ day of __, 19____.
For the [Wellington Bootmakers’ Industrial Union of Workers],
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.

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Form 13 (Reg. 21).
HEADING OF DOCUMENTS.
No. __.
BEFORE the Board of Conciliation [or the Court of Arbitration, 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.

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Form 14 (Reg. 22).
(Title, as in Form 13.)
NOTICE CONVENING BOARD.
I HEREBY convene a meeting of the Board of Conciliation, to be held at __, on the __ day of __, 19, at __ o’clock in the __ noon, for the purpose of inquiring into and investigating this dispute.
Dated at __, this __ day of __, 19.
__, Clerk of Awards.

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Form 15 (Reg. 25).
(Title, as in Form 13.)
NOTICE OF MEETING OF BOARD.
TAKE notice that the Board of Conciliation will meet at __, on the __ day of __, 19, at __ o’clock in the __ noon, to inquire into and investigate this industrial dispute.
Dated at __, this __ day of __, 19.
__, Clerk of Awards.

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Form 16 (Reg. 26).
(Title, as in Form 13.)
WARRANT TO APPEAR AS AGENT, ETC.
A. B., of __, [Address and occupation], is hereby authorised to appear and act for the [Bootmakers’ Industrial Union of Employers] as agent [or solicitor, or counsel, as the case may be] in the matter of this Reference.
Dated at __, this __ day of __, 19____.
For the [Bootmakers’ Industrial Union of Employers],
C. D., Chairman.
[Or otherwise, as the rules of the Union may prescribe.]

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Form 17 (Reg. 27).
(Title, as in Form 13.)
CONSENT TO APPEARANCE OF COUNSEL OR SOLICITOR.
APPEARANCE of counsel or solicitor before Board [or Committee, or Court, as the case may be] is hereby consented to by all the parties to this industrial dispute.
[Signatures of all the parties]:
A. B.,
C. D., &c.

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Form 18 (Reg. 28).
Under “The Industrial Conciliation and Arbitration Act, 1900.”
MEMORANDUM OF SETTLEMENT.
(Title, as in Form 13.)
We, the undersigned parties to the above-named industrial dispute, hereby signify our concurrence in the recommendation of the Board, filed in the office of the Clerk of Awards as No. __ [Add where necessary, with the following modifications, that is to say: (setting out the modifications agreed to)], and agree to accept such recommendation [with the above-mentioned modifications] as a settlement of such industrial dispute.
Dated at __, this __ day of __, 19____.
[Signatures of consenting parties]:
A. B.,
C. D., &c.

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Form 19 (Reg. 29).
Under “The Industrial Conciliation and Arbitration Act, 1900.”
MEMORANDUM OF CONSENT.
(Title, as in Form 13.)
We, the undersigned parties to the above-named industrial dispute, consent to accept the recommendation of the Board in respect of the above-mentioned dispute.
Dated at __, this __ day of __, 19____.
[Signatures of consenting parties]:
A. B.,
C. D., &c.

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Form 20 (Reg. 30).
(Title, as in Form 13.)
SUMMONS.
To A. B., of [Dunedin, Bootmaker], and C. D., of [Dunedin, Engine-driver].
You and each of you are hereby summoned to appear before the Board of Conciliation [or the Court of Arbitration, as the case may be] at __, on __, the __ day of __, 19, at __ o’clock in the __ noon, and thereafter from day to day until discharged from attendance, to give evidence concerning the above-named industrial dispute on behalf of __, party thereto [If the summons is to appear before the Court, add where necessary]; and you are also required to have and produce all books, papers, and other documents in your possession, custody, or control in any way relating to the matters in dispute, and in particular (but not exclusively) the following: [Stating them].
If you fail or neglect to comply with this summons you are liable to a penalty not exceeding £20, or to imprisonment not exceeding one month.
Dated at __, this __ day of __, 19____.
Issued in the name and on behalf of the Board of Conciliation [or the Court of Arbitration, as the case may be].
E. F.,
Clerk of Awards.

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Form 21 (Reg. 32).
(Title, as in Form 13.)
REFERENCE OF INDUSTRIAL DISPUTE TO COURT.
WHEREAS the recommendation of the Board of Conciliation in the above-named industrial dispute was filed on the day of __, 19, and neither an industrial agreement nor a memorandum of settlement has been filed in respect thereof, the undersigned, party to the said dispute, hereby refers the said dispute to the Court of Arbitration for settlement.
Dated at __, this __ day of __, 19.
For the [Wellington Bootmakers’ Industrial Union of Workers],
A. B., Chairman.
[Or otherwise, as the rules of the Union may prescribe.]
To the Clerk of Awards at __.