FEB. 18.]

THE NEW ZEALAND GAZETTE.

653

This license is granted for a term of years, commencing on the date hereof, subject to the terms, conditions, reservations, and provisions set out in the aforesaid Act and the regulations thereunder, and to such additional terms, conditions, reservations, and provisions as are specified in the Second Schedule hereto.
In witness whereof, &c.

FIRST SCHEDULE.
Description of the Mining Privilege, and of the Land to which it relates.
[Describe the privilege, land, and proposed work, as set out in the application--modified, however, so as to accord with the grant--adding such other particulars as are necessary.]
SECOND SCHEDULE.
[Set out additional terms, &c., if any.]

Form 39 (Reg. 57).
Under “The Mining Act, 1905.”
LICENSE FOR MINING PRIVILEGE GRANTED IN EXCHANGE OF TITLE UNDER FORMER MINING ACT.
[The ordinary form of license, with the addition of the following memorandum, to be noted or indorsed thereon under the hand of the Warden and the seal of the Court.]
MEMORANDUM.
The above license is granted in exchange for [Specify name, title, and registered number of surrendered mining privilege] (which has been duly surrendered for the purpose of such exchange), and confers the same priorities, and is subject to the same encumbrances, liens, and interests, as in the case of the surrendered mining privilege—to wit, the following:
[Set out the necessary particulars of the priorities, encumbrances, liens, and interests, if any.]
, Warden.

Form 40 (Reg. 57).
Under “The Mining Act, 1905.”
LICENSE FOR AMALGAMATED CLAIM.
[The ordinary form of license, with the following memorandum to be noted or indorsed thereon under the hand of the Warden and the seal of the Court.]
MEMORANDUM.
The above license is granted in amalgamation of the following claims—[Specify name, title, registered number, and area of each surrendered claim] (which have been duly surrendered for the purposes of such amalgamation)—and confers the same priorities, and is subject to the same encumbrances, liens, and interests, as in the case of the surrendered claims—to wit, the following:
[Set out the necessary particulars of the priorities, encumbrances, liens, and interests, if any.]
, Warden.

Form 41 (Reg. 57).
Under “The Mining Act, 1905.”
MINUTE OF SURRENDER OF MINING PRIVILEGE.
[To be noted or indorsed on the surrendered license under the hand of the Warden and the seal of the Court.]
SURRENDERED absolutely [or, as the case may be, for purposes of exchange or amalgamation] this day of , 19 , pursuant to application in this behalf.
, Warden.

Form 42 (Reg. 57).
[If the surrendered license is lost and cannot be produced, the minute of surrender is to be by separate instrument, under the hand of the Warden and the seal of the Court, as follows.]
THIS is to certify that, pursuant to application in this behalf, the mining privilege[s] specified in the schedule hereto is [are] this day surrendered absolutely [or, as the case may be, for purposes of exchange or amalgamation].
Dated at , this day of , 19 .

SCHEDULE.
[Set out name, locality, title, registered number, and holder of mining privilege(s) surrendered.] , Warden.

Form 43 (Reg. 57).
Under “The Mining Act, 1905.”
DECLARATION TO ACCOMPANY APPLICATION INVOLVING SURRENDER, WHETHER ABSOLUTELY OR FOR PURPOSES OF EXCHANGE OR AMALGAMATION, WHERE ALL OR ANY OF THE INSTRUMENTS OF TITLE ARE LOST.
In the matter of an application by involving surrender of title, which application is numbered in the Application Record-book at , in the Mining District.
I, A. B. [Full name, residence, and occupation], do hereby solemnly and sincerely declare as follows:—
(1.) That I am the applicant [or one of the applicants] named in the above-described application.
(2.) That I have made diligent search for such of the instruments of title referred to in the said application as are described in the Schedule hereto, but cannot find the same, and believe the same to be irrecoverably lost.
(3.) That the said instruments have not been lodged or deposited with any person for purpose of security for money or otherwise.
And I make this solemn declaration, conscientiously believing the same, under and by virtue of “The Justices of the Peace Act, 1882.”

SCHEDULE.
[Set out date, name, and registered number of each instrument of title.]
Declared at , this day of , 19 , before me— , a Justice of the Peace for the Colony of New Zealand [or as the case may be].

Form 44 (Regs. 11 and 59).
Under “The Mining Act, 1905.”
APPLICATION FOR RENEWAL OF LICENSE FOR MINING PRIVILEGE.
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 license specified in the Schedule, hereby applies for a renewal thereof for a term of years, commencing on the expiry of the current term.
Address for service:
Dated at , this day of , 19 .

SCHEDULE.
Particulars of Current License.
Date and registered number:
Name and locality of mining privilege:
Date of expiry of term:
[Signature of applicant, &c.]

Form 45 (Reg. 63).
Under “The Mining Act, 1905.”
CERTIFICATE OF REDUCTION.
THIS is to certify that, pursuant to “The Mining Act, 1905,” and on the application of [Full name and residence of holder of claim], being the holder of the claim specified in the Schedule hereto, the prescribed minimum number of workmen to be employed therein is hereby reduced to for the period of , commencing on the date hereof.
In witness whereof I have hereunto signed my name, and affixed the seal of the Warden’s Court at , this day of , 19 .