Mar. 28.] THE NEW ZEALAND GAZETTE. 765

return as far as the same is applicable to its particular case, and deliver the same at, or forward it by post to, the office of the Commissioner of Taxes, Wellington.
, Commissioner of Taxes.

RETURN of the Land and Mortgages of [Name in full, and postal address], made in pursuance of “The Land and Income Assessment Act, 1900,” and the Regulations thereunder, so far as respects all Land owned or leased by the Company, and all Mortgages held by the Company, as at Noon on the 31st Day of March, 19 , according to the several Particulars hereinafter set forth, and of Deductions at such Date as are allowed by Law.

Ordinary Tax.
Unimproved value of land owned by the company £
(particulars on page 3 hereof) .. .. ..
Add amount owing to the company—
(a.) On registered mortgage of land ..£
(b.) Unpaid purchase-money for land sold
(particulars on page 2 hereof) ..

Total .. .. .. ..
Deduct amount owing by the company—
(a.) On registered mortgage of land ..£
(b.) Unpaid purchase-money for land bought (particulars on page 2 hereof)

Balance .. .. £

Graduated Tax.
Unimproved value of land owned by the company
(particulars on page 3 hereof) .. .. ..£

I, , the duly appointed public officer of the above-named company, do solemnly and sincerely declare that the foregoing return is true and accurate in every particular. And I make this declaration under the provisions of “The Land and Income Assessment Act, 1900.”
Dated this day of , 19 .
[Usual signature.]

Particulars of Money owing to the Company—(a) Secured on Registered Mortgage; (b) in respect of Unpaid Purchase-money for Land sold—as at Noon on the 31st March, 19 .

Particulars of Money owing by the Company—(a) Secured on Registered Mortgage; (b) in respect of Unpaid Purchase-money for Land bought—as at Noon on the 31st March, 19 .

Particulars of Land owned by or leased to the Company as at Noon on the 31st March, 19 .

6. RETURN OF INCOME BY PERSON OR FIRM.
   “The Land and Income Assessment Act, 1900.”
   In pursuance of the above Act and of the regulations made thereunder, every person, whether liable to taxation under this Act or not, in receipt of income within the meaning of the said Act is required to fill up the following return as far as is applicable to his particular case, and deliver the same at, or forward it by post to, the office of the Commissioner of Taxes, Wellington, on or before the day of , 19 .
   , Commissioner of Taxes.

RETURN of the Income of [Name in full, occupation, and postal address], made in pursuance of “The Land and Income Assessment Act, 1900,” and the Regulations thereunder.

Income derived during the Year ending 31st March, 19 . Amounts. £

Gross Income from Business.

1. From interest of money deposited or lodged with any bank, society, company, firm, or person ..
2. From interest on unregistered mortgages, bonds, debentures, or like instruments ..
3. From annuities or other annual payments ..
4. From the trade, business, manufacture, or concern of , carried on by me at (as per details shown on page 3) .. ..
5. From pastoral lands of the Crown .. ..
6. From mining on Crown lands.. .. ..
7. From dividends paid or profits credited by any building society .. .. ..
8. From any source not coming within any of the foregoing heads [State source] .. ..

Total .. .. .. ..

Deductions (as per details shown on page 3).
Losses, outgoings, and expenses incurred in the production of the gross income stated above ..

Net income derived from business ..£

Gross Income from Employment or Emolument. Amount £

1. From the profession, employment, or vocation of .. .. .. ..
2. From salary, wages, allowances, bonus, pension, stipend, fees, charge, or annuity of any kind ..
3. From commissions or share of profits by way of or in lieu of salary .. .. ..
4. From any other source not coming within any of the foregoing heads (state source) .. ..

Total .. .. .. ..

Deductions (as per details shown on page 3).
Losses, outgoings, and expenses incurred in the production of the gross income stated above ..

Net income derived from employment or emolument .. .. .. ..£

I claim deduction on account of amount actually paid by me during the year as life-insurance premiums on my own life .. .. ..£

I, the person making the foregoing return, do solemnly and sincerely declare that it is true and accurate in every particular. And I make this declaration under the provisions of “The Land and Income Assessment Act, 1900.”
Dated this day of , 19 .
[Usual signature.]

I claim to deduct, from the net income shown on page 1, 5 per cent. of the capital value of interest in business premises as follows :—