2498
THE NEW ZEALAND GAZETTE.
[No. 92

14. The forms prescribed by these regulations can be obtained free of charge from the Secretary for Agriculture at Wellington, the Inspector of Stock at any New Zealand port, or any Inspector of Manure-sterilising.

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SCHEDULE.

FORM No. 1 (REGULATION No. 3, (1)).
Application for License to manufacture or prepare Animal Manure for Export to New Zealand.

In the matter of “The Stock Act, 1893” (New Zealand), and the Regulations thereunder.

To the Inspector of Manure-sterilising acting for New Zealand at .

I, [Wm.] , hereby apply for a license to manufacture or prepare animal manure for export to New Zealand at the works herein described, viz. :—

Name of the works :
Location of the works :
Kind of animal manure proposed to be manufactured or prepared :
Particulars (including capacity) of plant available for crushing bones :
Particulars (including capacity) of plant available for sterilising animal manure :
Size of building to be set apart solely for the grinding, conveying, screening, storage, &c., of animal manure after sterilisation :
Particulars (including capacity) of plant in the said building :
Name of shipping port :
Distance of works from shipping port :
Means of conveying animal manure from works to port :
Signature of owner or person in charge of the works :
Address :
Date : , 19 .

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FORM No. 2 (REGULATION No. 3, (2)).
License to manufacture or prepare Animal Manure for Export to New Zealand.

In the matter of “The Stock Act, 1893” (New Zealand), and the Regulations thereunder.

PURSUANT to the application of [Licensee’s name], of , dated the day of , 19 , this license is hereby granted and issued to the said in respect of the works described in the said application, and situated at .

This license is issued subject to the provisions of “The Stock Act, 1893,” and the regulations from time to time in force thereunder, restricting the importation of animal manure into New Zealand, and is in force until cancelled by me.

Dated at , this day of , 19 .
, Inspector of Manure-sterilising acting for New Zealand.

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FORM No. 3 (REGULATION No. 3, (5)).
Declaration to accompany Animal Manure exported to New Zealand.

In the matter of “The Stock Act, 1893” (New Zealand), and the Regulations thereunder.

I, , hereby solemnly and sincerely declare as follows :—

1. That the undermentioned consignment of animal manure has been duly treated as required by the above-mentioned Act and regulations at the works, at , of which I am owner or manager.

2. That the requirements specified in paragraphs (a) to (i) of clause 3, (5), of the regulations of the day of , 1905, have been faithfully complied with.

Particulars of Consignment.

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of an Act of the Imperial Parliament intituled “The Statutory Declarations Act, 1835.”

Signature :

Declared at , before me, this day of , 19 .

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The foregoing declaration is countersigned by me, at , this day of , 19 .
Inspector [or the Inspector’s authorised officer].

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FORM No. 4 (REGULATION No. 3, (10)).
Declaration by Master of Vessel respecting Animal Manure to be imported into New Zealand.

In the matter of “The Stock Act, 1893” (New Zealand), and the Regulations thereunder.

I, , master of the vessel “ ”, which is now lying at the Port of , do hereby solemnly and sincerely declare that the undermentioned consignment of animal manure was conveyed by the said vessel from the Port of to the Port of , and that during the time it was on board the said vessel, or being loaded into or unloaded from the said vessel, the said manure has not been brought into contact with any unsterilised animal manure.

Particulars of Consignment.

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of an Act, &c. (as in Form No. 3 above).

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FORM No. 5 (REGULATION No. 5).
Notice of Animal Manure ordered from India or Australia.

In the matter of “The Stock Act, 1893” (New Zealand), and the Regulations thereunder.

To the Secretary for Agriculture, at Wellington, New Zealand.

IN pursuance of regulations under “The Stock Act, 1893,” I hereby give notice that I have this day sent or caused to be sent an order for animal manure to be imported into New Zealand in accordance with the following particulars :—

Name and address of person to whom the order was sent :
Kind of animal manure ordered :
Quantity ordered :
When the manure is to be shipped :
Port from which the manure is to be shipped :
Port to which the manure is to be shipped :
Particulars of any brands, marks, or numbers to be placed on the bags :

Signature :
Address :
Date :

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FORM No. 6 (REGULATION No. 6).
Notice of Intention to introduce Animal Manure into New Zealand.

In the matter of “The Stock Act, 1893” (New Zealand), and the Regulations thereunder.

To the Inspector of Stock at .

TAKE notice that it is my intention to introduce into New Zealand from the Port of , per the vessel “ ” (expected to arrive at on the day of ), the undermentioned animal manure, which has been treated as required by the regulations under “The Stock Act, 1893” :—

Kind of animal manure :
Quantity :
Particulars of brands, marks, or numbers :
Signature of owner or agent :
Address :
Date :

ALEX. WILLIS,
Clerk of the Executive Council.