Mar. 18.] THE NEW ZEALAND GAZETTE. 849

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the Justices of the Peace Act, 1908.

Declared at , this
day of , 19 , before
me—
, Justice of the Peace
[or Solicitor of the Supreme Court].

A. B.

Form No. 5.

Debenture.

[Name of local authority], New Zealand.

[Name of loan] Loan.

Loan of [State amount] from the New Zealand State-guaranteed Advances Office.

Issue of [State number] debentures of [Not less than £20 nor more than £1,000] each, numbered 1 to , bearing interest at [State rate] per centum per annum.

These debentures are issued under the provisions of the New Zealand State-guaranteed Advances Act, 1909, and the Local Bodies’ Loans Act, 1908.

Debenture No. .

1. The [Full name of body corporate], being a body corporate under the [Name of Act], in consideration of the sum of [Not less than £20 nor more than £1,000] lent to the said body corporate by the New Zealand State-guaranteed Advances Office Superintendent, do hereby bind themselves [or itself] to pay to the said Superintendent or to the bearer of this debenture the said sum of [State amount], together with interest thereon at the rate of [State rate] per centum per annum.

2. The said principal and interest shall be payable in accordance with the table of repayments indorsed hereon by equal half-yearly instalments of [State amount in accordance with indorsed table] during a period of thirty-six and a half years, the first of those instalments being payable on the [State date six months after the date of the loan] day of , 19 .

3. The said instalments shall include both principal and interest in accordance with the indorsed table, and full payment thereof shall constitute a complete discharge of this debenture.

4. All sums payable under this debenture shall be paid at the office of the said Superintendent at Wellington.

5. The said body corporate hereby charges, as security for the payment of all moneys payable under this debenture and the other debentures of the same series, a special rate of [Insert sufficient description of special rate].

6. By way of further security for the said moneys, the said body corporate hereby charges [Insert sufficient description of any other security given for the loan].

7. The holder of this debenture has no claim in respect thereof upon the Government or public revenues of New Zealand.

Issued under the common seal of the [Full name of body corporate], the day of , 19 .

A. B., Mayor [or Chairman].

C. D., Treasurer [or other officer appointed to countersign debentures].

[Indorse appropriate Table of First Schedule.]

Form No. 6.

Declaration verifying due Execution of Debentures.

I, A. B., Mayor [or Chairman, or Clerk] of [Name of local authority], do solemnly and sincerely declare,—

1. That a resolution was passed at a meeting of [Name of local authority] duly called and constituted, held on , the day of , 19 , authorising the common seal of [Full name of body corporate] to be affixed to the debentures numbered 1 to , issued in respect of the loan of £ from the New Zealand State-guaranteed Advances Office.

2. That the said common seal was duly affixed to the said debentures in accordance with the said resolution.

3. That C. D., whose signature appears on the said debentures, is the Treasurer [or other officer] of [Name of local authority], and has been appointed by the said local authority to countersign those debentures.

4. That the signature “ A. B.” on the said debentures is the proper handwriting of me, this deponent.

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the Justices of the Peace Act, 1908.

Declared at , this
day of , 19 , before
me—
, Justice of the Peace
[or Solicitor of the Supreme Court].

A. B.

J. F. ANDREWS,
Clerk of the Executive Council.

P