1066
THE NEW ZEALAND GAZETTE.
[No. 48

to the Clerk of Awards] for the use of the said I. B., and also
within the same period do pay the said sum of £
ap-
portioned to or for the benefit of the said K. B., and also the
said sum of £
apportioned to or for the benefit of the
said L. B., to the Clerk of Awards.

6. And we order that the said last-mentioned sums be in-
   vested by the Clerk of Awards in his name in the Post-Office
   Savings-Bank for the benefit of the said K. B. and L. B. re-
   spectively, and that the interest arising from such invest-
   ment be from time to time, until further order, paid to the
   said I. B., to be by her applied for the maintenance or
   benefit of the said K. B. and L. B. respectively.

7. And we order that the said C. D. and Co. within four-
   teen days from the date hereof do pay to the Clerk of
   Awards, for the use of the claimants, their costs of and
   incident to this arbitration, which we assess at the sum
   of £
   .
   Dated this
   day of
   , 19
   , President.

(Form 14. Reg. 22.)

AWARD IN CASE OF APPLICATION FOR MEDICAL AND BURIAL
EXPENSES.

[Heading as in Form 1.]

HAVING duly considered the matters submitted to us, we
do hereby make our award as follows:—

1. We order that the respondents, C. D. and Co., do pay
   the sum of £
   for or towards the expenses of medical
   attendance on and the burial of A. B., late of
   ,
   deceased, who died on the
   day of
   , from
   injury caused on the
   day of
   by accident
   arising from and in course of the employment of the said
   A. B. as a worker employed by the said C. D. and Co.
   in [State nature of employment].

2. And we declare that the persons hereinafter named are
   entitled to share in such compensation, that is to say,—
   The claimant, E. F., in respect of charges amounting to
   £
   due to him for medical attendance on the said
   A. B., and the respondent, G. H., in respect of charges
   amounting to £
   due to him for the burial of the said
   A. B.

3. And we order that the respondents, C. D. and Co.,
   within fourteen days from the date hereof, do pay the said
   sum of £
   to the Clerk of Awards, and that the said
   sum be apportioned between and paid to the said E. F. and
   G. H. in proportion to the amounts due to them respectively
   as aforesaid.

4. And we order that the said C. D. and Co., within four-
   teen days from the date hereof, do pay to the Clerk of Awards
   for the use of the claimant, E. F., and the respondent,
   G. H., their respective costs of and incident to this arbitra-
   tion, which we assess as follows: The costs of the said E. F.
   the sum of £
   , and the costs of the said G. H. the
   sum of £
   .
   Dated this
   day of
   , 19
   , President.

[NOTE.—This and the two last preceding forms will serve
as guides for framing awards in other cases of arbitration.]

(Form 15. Reg. 25.)

APPLICATION TO ENFORCE PAYMENT.

[Heading as in Form 1.]

WHEREAS by the award of the Court in the above-mentioned
arbitration it was ordered that C. D. and Co. [Set out terms
of award in which default has been made]: And whereas
default has been made by the said
in payment of
the said sum of £
[or in payment of the instalment,
amounting to
, due under the said award on the
day of
]: Now I, the undersigned A. B.
[or other person entitled], do hereby apply to the Court
for the enforcement of the award herein referred to.
Dated this
day of
, 19
.
(Signed)
A. B.

(Form 16. Reg. 25.)

CERTIFICATE OF CLERK OF AWARDS.

[Heading as in Form 1.]

THIS is to certify that on the
day of
the
Court did award that the sum of £
should be payable
by C. D. and Co., of
, to A. B. [or other person en-
titled], and that the said amount is now [or as the case may
be] payable under the said award.
Dated at
, this
day of
, 19
, Clerk of Awards.
[Seal.]

(Form 17. Reg. 28.)

APPLICATION TO SUSPEND WEEKLY PAYMENTS.

[Heading as in Form 1.]

TAKE notice that I intend to apply to the Court at
,
on
, the
day of
, at the hour of
noon [on behalf of Messrs. C. D.
and Co., of
], for an order suspending the weekly
payments awarded to you by award of the Court in the
above-mentioned matter, on the ground that you refuse to
submit yourself to medical examination as required by me
[or by the said C. D. and Co.] in accordance with clause 5 of
the Second Schedule to the Act [or that you obstruct the
medical examination required by me, &c.], and for conse-
quential directions, and for costs.
Dated this
day of
, 19
.
(Signed)
C. D. and Co.
[or Solicitors for C. D. and Co.]
To A. B., of
, and to Messrs.
,
his solicitors.

(Form 18. Reg. 29.)

APPLICATION TO REVIEW OR REDEEM WEEKLY PAYMENTS.

[Heading as in Form 1.]

TAKE notice that I intend to apply to the Court at
,
on
, the
day of
, at the hour of
noon, for an order reviewing [or to redeem] the
weekly payments payable under the award of the Court in
the above-mentioned matter, and that the same may be
terminated [or diminished, or increased, or redeemed, as the
case may be], on the grounds that [Set out grounds of appli-
cation concisely].
Dated this
day of
, 19
.
(Signed)
……………, Worker
(or Worker’s Solicitor)
. [or ……………, Employer
(or Employer’s Solicitor)].
To A. B., of
, and to Messrs.
, his
solicitors
[or To Messrs. C. D. and Co., and to Messrs.
,
their solicitors, as the case may be].

(Form 19. Reg. 30.)

APPLICATION FOR CERTIFICATE OF BOARD OF CONCILIATION
UNDER SECTION 14 OF THE ACT.

WE, the undersigned, hereby apply to the Board of Concilia-
tion for the [Northern] Industrial District for a certificate
under section 14 of “The Workers’ Compensation for Acci-
dents Act, 1900,” that the scheme for compensation (a copy
of which is appended hereto) is, on the whole, not less
favourable to the general body of workers and their de-
pendants than the provisions of the Act.
Dated at
, this
day of
, 19
.
To the Clerk of Awards.
C. D. and Co.

(Form 20. Reg. 30.)

CERTIFICATE OF BOARD OF CONCILIATION.

In the [Northern] Industrial District.

HAVING considered the application dated the
day
of
, and made by C. D. and Co., of
, under
section 14 of “The Workers’ Compensation for Accidents
Act, 1900,” I hereby certify that the Board of Conciliation
for the above-mentioned district are of opinion that the
scheme for compensation submitted by the said C. D. and
Co. is, on the whole, not less favourable to the general body
of workers and their dependants than the provisions of the
Act.
Dated this
day of
, 19
.
, Chairman.

As witness the hand of His Excellency the Governor,
this thirteenth day of May, one thousand nine
hundred and one.

WM. HALL-JONES.

Regulations for the Compulsory Taking of Land under “The
Land for Settlements Consolidation Act, 1900.”

RANFURLY, Governor.

WHEREAS, in exercise of the powers in that behalf
conferred on him by “The Land for Settlements
Act, 1894,” His Excellency the Governor of the Colony of
New Zealand did, on the third day of June, one thousand
eight hundred and ninety-seven, make certain regulations for
the forms of requisitions and claims under that Act, and the
time within and the manner in which should be done any-
thing in that Act expressed to be prescribed: And whereas
the said regulations were gazetted on the tenth day of
June, one thousand eight hundred and ninety-seven: And
whereas that Act was repealed by “The Land for Settle-
ments Consolidation Act, 1900” (hereinafter called “the
said Act”), which, however, provides that all regulations
made under any power contained in any repealed Act shall
be deemed to have been made under the said Act, and
shall continue in force until revoked by the Governor under
the said Act: And whereas by the said Act it is further