1118
THE NEW ZEALAND GAZETTE.
[No. 27

FORM 1.
[Reg. 4.
"The Coal-mines Act, 1905."
FIRST-CLASS MINE-MANAGER'S CERTIFICATE.
No.
Office of Board of Examiners,
Wellington, , 1 .
THIS is to certify that [State the name in full, address, and occupation of person examined] has produced a certificate from his previous employers that he has been actually engaged in underground workings in a mine for a period of not less than five years, and has passed a satisfactory examination as a first-class mine-manager of a coal-mine, as required by sections 24 to 26 of "The Coal-mines Act, 1905," and the regulations made thereunder.
A. B.,
Chairman of Board of Examiners.
Entered, Vol. , folio .
C. D., Secretary.

FORM 2.
[Reg. 4.
"The Coal-mines Act, 1905."
SECOND-CLASS MINE-MANAGER'S CERTIFICATE.
No.
Office of Board of Examiners,
Wellington, , 1 .
THIS is to certify that [State the name in full, address, and occupation of person examined] has produced a certificate from his previous employers that he has been actually engaged in underground workings in a mine for a period of not less than five years, and has passed a satisfactory examination as a second-class mine-manager of a coal-mine, as required by sections 24 to 26 of "The Coal-mines Act, 1905," and the regulations made thereunder.
A. B.,
Chairman of Board of Examiners.
Entered, Vol. , folio .
C. D., Secretary.

FORM 3.
[Reg. 4.
"The Coal-mines Act, 1905."
MINE-MANAGER'S CERTIFICATE OF COMPETENCY.
Office of Board of Examiners,
Wellington, , 1 .
THIS is to certify that [State the name in full, address, and occupation of applicant] has produced a mine-manager's certificate from a recognised authority outside the Dominion, and has satisfied the Board of Examiners that he is entitled to a mine-manager's certificate of competency under the provisions of section 27 of "The Coal-mines Act, 1905," and this certificate is issued in compliance therewith.
A. B.,
Chairman of Board of Examiners.
Entered, Vol. , folio .
C. D., Secretary.

FORM 4.
[Reg. 10.
"The Coal-mines Act, 1905."
STATISTICS OF WORKINGS IN COAL-MINES, 19

• Companies of limited liability only.

FORM 5.
[Reg. 24.
"Under "The Coal-mines Act, 1905," and Amendments.
APPLICATION FOR A COAL LEASE.
[If the land is situate wholly outside a mining district the application must be made to the Commissioner of Crown Lands of the land district, and this form must be altered accordingly.]
To the Warden of the Mining District, at .
Pursuant to "The Coal-mines Act, 1905," and amendments, the undersigned [Full name, residence, and occupation] hereby applies for a coal lease in respect of the following land :—
[Here specify and identify the land with reasonable particularity by reference to its area, situation, and ownership.]
Mark on pegs :
Address for service :
Dated at , this day of , 19 .
Signature of applicant :
A. B.
[Or, as the case may be,
A. B.
(by his Solicitor or Registered Agent, C. D.).]
Precise time of marking out privilege applied for: [e.g., 6th March, 1908, at 2.30 p.m.]
Time and place appointed for the hearing of the application and all objections thereto: [e.g., Monday, 23rd March, 1908, at 10 a.m., at Warden's Court at .]
Objections must be filed in the Registrar's office and notified to applicant at least three days before the time so appointed.
, Mining Registrar.

FORM 6.
[Reg. 24.
Under "The Coal-mines Act, 1905," and Amendments.
APPLICATION FOR LICENSE TO PROSPECT FOR COAL.
[If the land is situate wholly outside a mining district the application must be made to the Commissioner of Crown Lands of the land district, and this form must be altered accordingly.]
To the Warden of the Mining District, at .
Pursuant to "The Coal-mines Act, 1905," and amendments, the undersigned [Full name, residence, and occupation] hereby applies for a license to prospect for coal in respect of the following land :—
[Here specify and identify the land with reasonable particularity by reference to its area, situation, and ownership.]
Mark on pegs :
Address for service :
Dated at , this day of , 19 .
Signature of applicant :
A. B.
[Or, as the case may be,
A. B.
(by his Solicitor or Registered Agent, C. D.).]
Precise time of marking out privilege applied for: [e.g., 6th March, 1908, at 2.30 p.m.]
Time and place appointed for the hearing of the application and all objections thereto: [e.g., Monday, 23rd March, 1908, at 10 a.m., at Warden's Court at .]
Objections must be filed in the Registrar's office and notified to applicant at least three days before the time so appointed.
, Mining Registrar.