650 THE NEW ZEALAND GAZETTE. [No. 16

Form 20A (Reg. 33).
Under “The Mining Act, 1905.”
APPLICATION FOR A MINERAL LICENSE.
[As in Form 15, with all necessary modifications, including Schedule as follows.]

SCHEDULE
Locality where license is situate, with its boundaries, measurements, and area.

Form No. 21 (Reg. 33).
Under “The Mining Act, 1905.”
APPLICATION TO SURRENDER MINING PRIVILEGE[S] ABSOLUTELY.

To the Warden of the Mining District, at .
Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the mining privilege[s] specified in the Schedule hereto, hereby applies to surrender the same absolutely, and not for the purpose of exchange.
Address for service:
Dated at , this day of , 19 .

SCHEDULE.

[Signature of applicant, &c.]
Precise time, &c.

Form 22 (Reg. 33).
Under “The Mining Act, 1905.”
APPLICATION FOR EXCHANGE FOR TITLE UNDER “THE MINING ACT, 1905.”

To the Warden of the Mining District, at .
Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the mining privilege specified in the Schedule hereto, hereby applies to surrender the same, and to obtain in substitution therefor a license for a corresponding mining privilege under that Act.
Address for service:
Dated at , this day of , 19 .

SCHEDULE.
Name of mining privilege proposed to be surrendered, and the Act under which the title is held:
Locality and area of mining privilege:
Existing instrument of title, with date and registered number:
Whether instrument produced or not:
Time from which priority is claimed:
Name of proposed corresponding mining privilege:
Proposed term of new license:
[Signature of applicant, &c.]
Precise time, &c.

Form 23 (Reg. 33).
Under “The Mining Act, 1905.”
APPLICATION FOR AMALGAMATION OF CLAIMS.

To the Warden of the Mining District, at .
Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the claims specified in the Schedule hereto, and being desirous of facilitating the working thereof, and simplifying the titles thereto, hereby applies to surrender the same, and to obtain in substitution therefor a license for an amalgamated claim.
Address for service:
Dated at , this day of , 19 .

SCHEDULE.

[Signature of applicant, &c.]
Precise time, &c.

Form 24 (Regs. 33 and 63).
Under “The Mining Act, 1905.”
APPLICATION FOR CERTIFICATE OF REDUCTION.

To the Warden of the Mining District, at .
Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the claim specified in the Schedule hereto, hereby applies for a certificate reducing to the extent and for the period therein specified, or to such lesser extent and for such lesser period as the Warden thinks fit, the prescribed minimum number of workmen to be employed in working the said claim.
Address for service:
Dated at , this day of , 19 .

SCHEDULE.
Name, locality, and area of claim:
Title under which claim is held, with registered number (if any):
Date when originally taken up:
Present prescribed minimum number of workmen:
Extent of reduction desired (being the maximum number that can reasonably be employed):
Period for which the reduction is desired:
[Signature of applicant, &c.]
Precise time, &c.

Form 25 (Regs. 33 and 65).
Under “The Mining Act, 1905.”
APPLICATION FOR CERTIFICATE OF PROTECTION.

To the Warden of the Mining District, at .
Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], hereby applies for a protection certificate for the period of in respect of the mining privilege[s] specified in the Schedule hereto.
Address for service:
Dated at , this day of , 19 .

SCHEDULE.

[Signature of applicant, &c.]
Precise time, &c.

Form 26 (Regs. 33 and 67).
Under “The Mining Act, 1905.”
APPLICATION FOR CERTIFICATE OF EASEMENT.

To the Warden of the Mining District, at .
Pursuant to “The Mining Act, 1905,” the undersigned [Full name, residence, and occupation], being the holder of the following mining privilege—[Specify its name, locality, and registered number]—hereby applies for a certificate of easement in respect of the land specified in the First Schedule hereto, which has been duly marked out for the purpose, and is portion of the mining privilege specified in that Schedule.

The works to be constructed and the rights to be exercisable under the certificate of easement are as specified in the Second Schedule hereto.
Address for service:
Dated at , this day of , 19 .

FIRST SCHEDULE.
[Specify the land with reasonable particularity, as also the name, locality, registered number (if any), and holder of the mining privilege in which such land is comprised.]

SECOND SCHEDULE.
[Specify with reasonable particularity the works to be constructed and the rights to be exercised under the certificate.]
[Signature of Applicant, &c.]
Precise time, &c.