Mar. 23.] THE NEW ZEALAND GAZETTE. 1053

5. Name or style under which the business of the factory
   is to be carried on :
6. Number of rooms, and dimensions of each :
7. Means of ventilation :
8. Lavatories : . Closets : . Urinals :
9. Means of escape in case of fire :
10. Maximum number of persons to be employed therein—
    Male : . Female :
11. The number of persons at present employed, or to be
    employed, with the rate of wages paid to each, are
    shown on attached form F 2B or 2c.

I [or We] declare these particulars to be true in every
respect.

Date : , 191 . , Occupier [or Intended Occupier].

Form F 2B.

Under the Factories Act, 1908 (Sections 11 and 16).

“ FOLLOW-ON ” FORM.

(To follow Form F 2A or F 3A, as required.)

Name of occupier of factory : .
Address : .
Trade : .
Total amount of wages paid (if any) in this trade during the
year ending 31st March, 191 : £ .

(NOTE.—Where there is more than one department or trade,
each department or trade to be shown on separate form).

The persons at present employed, or to be employed, in
this trade, and the rate of wages paid per week to each (i.e.,
for an ordinary full week), are as follow :—

at , at ,
at , at ,
at , at . | Aged under 16 years,—
at , at ,
at , at ,
at , at . |
| Aged 16 years and under 20,—
at , at ,
at , at ,
at , at . | Aged 16 years and under 20,—
at , at ,
at , at ,
at , at . |
| Aged 20 years and over,—
at , at ,
at . | Aged 20 years and over,—
at , at ,
at . |

Total male employees : . Total female employees : .

Occupiers (including owners, managers, and others personally engaged in the work of the factory).—Each person to be shown in that trade in which he or she is principally engaged :—

Number of males : . Number of females : .
(Wages not required.) (Wages not required.)

(If additional space is required for this trade, use back of form.)

Form F 2c.

Under the Factories Act, 1908 (Sections 11 and 16).

“ FOLLOW-ON ” FORM.

(To follow Form F 2A or F 3B, as required.)

Name of occupier of factory : .
Address : .
Trade : .
Total amount of wages paid (if any) in this trade during the
year ending 31st March, 191 : £ .

(NOTE.—Where there is more than one department or trade,
each department or trade to be shown on separate form.)

The persons at present employed, or to be employed, in
this trade, and the rate of wages paid per week to each (i.e.,
for an ordinary full week), are as follow :—

at , at ,
at , at ,
at , at . | Aged under 16 years,—
at , at ,
at , at ,
at , at . |
| Aged 16 years and under 20,—
at , at ,
at , at ,
at , at . | Aged 16 years and under 20,—
at , at ,
at , at ,
at , at . |
| Aged 20 years and over,—
at , at ,
at . | Aged 20 years and over,—
at , at ,
at . |

Form F 2D.

Under the Factories Act, 1908
(Section 14).

[Coat of arms.]

CERTIFICATE OF REGISTRATION.

This is to certify that the premises occupied by
, known as , in which
persons are employed, have this day been registered
for manufacture of , under the Factories Act, 1908, as a factory for the
manufacture of or preparing for manufacture of
, and that the registration fee of
for the
year ending 31st March, 191 , has been paid.

Date : , 191 .
[Initials of Inspector.]

RECEIVED from the sum
for the registration
fee.

[Date-stamp.]
, Inspector.

Form F 3A.

Under the Factories Act, 1908 (Sections 11 and 16).

APPLICATION FOR RENEWAL OF REGISTRATION OF FACTORY.
(To be served on Inspector.)

[Address of factory], , 191 .

To the Inspector of Factories,

I [or WE] hereby make application for the renewal of the
registration of my [or our] factory under the Factories Act,
1908. The following are the particulars required ; and I
[or we] hereby declare the same to be correct in every particular :—

The total number of persons (including occupiers) at present
employed, or to be employed, in or about the factory is
, for which the registration fee of £ , as per scale below,
is enclosed.

[Signature of occupier.]