730
THE NEW ZEALAND GAZETTE.
No. 19

No. 6. Admission of Claim.
The defendant admits that the plaintiff is entitled to the relief claimed by him [Or state any
relief which the defendant admits the plaintiff to be entitled to].
[Or where a weekly sum is claimed by way of compensation,] The defendant admits his
liability to pay compensation in this action, and submits to judgment for the payment by him to
the plaintiff of the weekly sum of as from the day of , 19, at such times
and in such manner as the Court thinks fit.

No. 7. Discontinuance.
The plaintiff hereby discontinues this action.

No. 8. Summons of Witness.
To A. B., of , and C. D., of .
Take notice that you and each of you are hereby summoned to appear before the Court of
Arbitration at , on , the day of , 19, at o'clock in the
noon, and thereafter from day to day until discharged from attendance, to give evidence
in this action on behalf of the plaintiff [or defendant].
[Add, where necessary,]
And you are also required to have and produce all books, papers, and other documents in your
possession, custody, and control in any way relating to the matters in dispute in this action, and
in particular the following: [Stating them].
Dated this day of , 19.

(Seal.)
E. F.,
Clerk of Awards.

No. 9. Notice of Time and Place of Hearing.
Take notice that the trial of this action [or the hearing of this motion] will take place before
the Court of Arbitration [or the Judge of the Court of Arbitration] on , the day
of , 19, at o'clock in the noon at [State place of trial-e.g., Supreme
Court, Wellington].
Dated this day of , 19.

(Seal.)
Clerk of Awards.

No. 10. Third-party Notice.
To [Name, address, and calling of third party].
Take notice that this action has been brought by the plaintiff against the defendant to recover
compensation under the Workers' Compensation Act in respect of [Here state generally the nature
of the cause of action]. A copy of the statement of claim in the action is hereunto annexed.
The defendant claims to be indemnified by you against his liability to pay such compensation
on the ground that [Here state the ground on which indemnity is claimed].
If you wish to dispute the plaintiff's claim as against the defendant, you must appear before
the Court of Arbitration at the trial of this action, and must also file a statement of defence setting
forth any ground of defence other than those set out in the statement of defence filed by the
defendant.
The action will be tried at [State place, day, and hour appointed for the trial, or, if no
appointment has been made before the issue of this notice, add the words, "a time and place of
which due notice will hereafter be given to you"]
In default of your so appearing you will be deemed to admit the validity of any judgment
given in the action.
The plaintiff's address for service is
The defendant's address for service is
Dated this day of , 19.
(Signature of Defendant, his Solicitor, or Agent.)

No. 11. Certificate of Clerk of Awards.
(To be filed in the Supreme Court or Magistrate's Court.)
New Zealand.
In the Court of Arbitration, [Northern] Industrial District.
In the matter of the Workers' Compensation Act, 1908.
I hereby certify that on the day of , 19, the Court of Arbitration [or the
Judge of the Court of Arbitration] gave judgment [or made an order] for the payment by [State
the name, address, and calling of the debtor] to [State the name, address, and calling of the
creditor] of the sum of [State the full amount of the judgment or order, with particulars (if any)
as to mode of payment--e.g., one pound per week]: