FEB. 2.] THE NEW ZEALAND GAZETTE. 429

8. A copy of each of the newspapers referred to in this application is forwarded herewith [and
   also a copy of the special roll and a tracing or map of the special-rating area].
   [9. The special roll was prepared in accordance with section 3 of the Local Bodies’ Loans Act,
   1908, as amended by section 5 of the Local Bodies’ Loans Amendment Act, 1910, and deposited for
   public inspection at the office of the [Name of local authority] from to , 19 ;
   and public notice thereof was published in the newspaper on the day of
   19 , and no valid objection was lodged against the said roll.]

A. B.,
Mayor [or Chairman, or Clerk].

Form No. 5.

Application for a Loan under the New Zealand State-guaranteed Advances Act, 1909.

(Where loan to be raised by special order only.)

Application of [Name of local authority].
Amount of loan applied for : £
Term of loan : Thirty-six years and a half, on the instalment system.
Purpose for which loan required : .
Special-rating district or area : .
Date of application : .

To the Superintendent (Advances to Local Authorities Branch), New Zealand State-guaranteed
Advances Office, Wellington.

1. THE above-named local authority hereby applies for a loan of £ , in respect of which a
   preliminary application was made on the day of , 19 , and provisionally approved
   by the New Zealand State-guaranteed Advances Board, as notified by you on the day
   of , 19 .

2. The terms and conditions on which this loan is applied for are,—
   (a.) The loan is for the purpose of [State purpose], which is to cost £ .
   (b.) The rate of interest to be per centum per annum.
   (c.) The term to be thirty-six years and a half, and loan to be repaid by instalments in
   accordance with the appropriate table.
   (d.) The loan-money is required on the day of , 19 [or in instalments
   of (State amounts and dates of instalments of loan, not exceeding five)].
   (e.) The security for repayment of the loan is,—
   (i.) A special rate of in the pound over [Describe special-rating district
   or area].
   (ii.) [State any other security.]

3. The special order authorizing the raising of the loan was duly made or adopted on the
   day of , 19 , and confirmed on the day of , 19 ; and public
   notifications thereof were duly given in the newspaper of the , 19 . A copy of
   the special order, under seal, is hereto attached, marked “ A.”

4. The resolution making a special rate of in the pound on all rateable property in
   the said special-rating district was duly passed on the day of 19 ; and public
   notification thereof was duly given in the New Zealand Gazette of the , 19 (page ). A
   copy of the resolution, under seal, is hereto attached, marked “ B.”

5. The rateable valuation of all rateable property in the special-rating district is £ , and the
   special rate of in the pound thereon will yield an annual sum of £ , which is sufficient
   to meet 10 per centum more than the periodical payments in respect of the loan as they fall due.

6. All statutory and other proceedings have been duly taken and all conditions have been duly
   fulfilled which are necessary for the raising of the said loan and for the making of the said special rate
   as a security therefor.

7. A copy of each of the newspapers referred to in this application is forwarded herewith.

A. B.,
Mayor [or Chairman, or Clerk].

Form No. 6.

Declaration verifying Application for Loan.

I, A. B., Mayor [or Chairman, or Clerk] of [Name of local authority], do solemnly and sincerely declare
that the statements contained in the foregoing application are true and correct in every particular.

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 } A. B.
me— }
, Justice of the Peace
[or Solicitor of the Supreme Court].

• This is required in every case where special-rating area is not a legal subdivision of a district.