830
THE NEW ZEALAND GAZETTE.
[No. 17

NEW ZEALAND TO WIT.
[Form No. 6.
In the matter of Part III of the Infants Act, 1908; and in
the matter of an application by

to adopt

CONSENT TO ORDER OF ADOPTION.
I, [Full name, address, and occupation], being the legal
guardian of
, a [Sex] [State whether legitimate or
illegitimate] child, born on or about the
day of
, 19
, do hereby consent to an order being made under
Part III of the Infants Act, 1908, for the adoption of the
said
by
, of
, and
,
his wife [or as the case may be].
Dated at
, this
day of
, 19
.
[Signature.]
[Witness.]

(NOTE.—Witness may be a Stipendiary Magistrate, Justice
of the Peace, Clerk of Court, or a solicitor.)

NEW ZEALAND, TO WIT.
[Form No. 7.
In the matter of Part III of the Infants Act, 1908; and in
the matter of an application by
to adopt

SUMMONS TO A WITNESS.
To [Name in full, description, and residence of witness].
You are hereby commanded to attend before the Magistrate
in Chambers at the Magistrate’s Court at
, on
the
day of
, 19
, at the hour of
o’clock in the
noon, to give evidence on behalf of
[State name of party requiring evidence of witness], [and
then and there to have and produce (State any particular
documents required), and all other books, papers, writings,
and other documents relating to the said matter which may
be in your custody, possession, or power.] Herein fail not at
your peril.
Given under my hand and the seal of the Court, at
, this
day of
.19
,
Clerk of the Court
[or Justice of the Peace].

NEW ZEALAND, TO WIT.
[Form No. 8.
In the matter of Part III of the Infants Act, 1908; and in
the matter of an application by
to adopt

I,
, of
,
make oath and say as fol-
lows:—

1. That I know the said
   and the said
   ,
   that they are of good repute, that I believe them to be
   fit and proper persons to have the care and custody of the
   said
   , that they are of sufficient ability to bring up,
   maintain, and educate the said child, and that the welfare
   and interests of the said child will be promoted by the
   adoption.
   Sworn at
   , this
   day of
   , 19
   , before
   me—
   , Justice of the Peace
   [or Clerk of Court, or Solicitor].

NEW ZEALAND, TO WIT.
[Form No. 9.
In the matter of Part III of the Infants Act, 1908; and in
the matter of an application by
to adopt

ORDER OF ADOPTION UNDER SECTION 16 OR 17.
WHEREAS on the
day of
, 19
, an applica-
tion, under section
of the Infants Act, 1908, was
duly filed in the Magistrate’s Court at
, by
,
of
, and
, his wife, for an order to
adopt
, a [Sex] [State whether legitimate or illegiti-
mate] child, born on the
day of
, 19
: And
whereas all the conditions and requirements of the said Act
and the rules made thereunder relating to the adoption of
children have been duly complied with and fulfilled, and I
am satisfied of the several matters of which by the said Act
I am required to be satisfied:
Now, therefore, I,
, Stipendiary Magistrate, do
hereby order and adjudge that the said
male
child named
may be and is hereby adopted by the
said
, and
, his wife, and each of them, under
section 16 [or section 17] of the said Act as from the date
hereof, and shall thenceforth bear the name of
.
Given under my hand, at
, this
day of
, 19
.
, Stipendiary Magistrate.

NEW ZEALAND, TO WIT.
[Form No. 10.
In the matter of Part III of the Infants Act, 1908; and in
the matter of an application by
to adopt

ORDER OF ADOPTION UNDER SECTION 24.
WHEREAS, on the
day of
, 19
, an applica-
tion under section 24 of the Infants Act, 1908, was duly filed
in the Magistrate’s Court at
by
, manager of
the [Designation of institution], situated at
, and
established in connection with the
religious denomi-
nation, for an order to adopt a
male
deserted
child, born on or about the
day of
, 19
:
And whereas all the conditions and requirements of the said
Act and the rules made thereunder relating to the adoption
of children have been duly complied with and fulfilled, and I
am satisfied of the several matters of which by the said Act
I am required to be satisfied:
Now, therefore, I,
, Stipendiary Magistrate, do
hereby order and adjudge that the said
male
deserted child named
may be and is hereby adopted
by the said
in connection with the said institution,
under section 24 of the said Act, as from the date hereof.
Given under my hand, at
, this
day of
, 19
.
, Stipendiary Magistrate.

SECOND SCHEDULE.
SCALE OF FEES IN RESPECT OF PROCEEDINGS UNDER
PART III OF THE INFANTS ACT, 1908, IN RESPECT OF
THE ADOPTION OF CHILDREN.

Filing any application, affidavit, or statutory de-
claration
.. .. .. .. .. .. .. .. .. 2 0
Filing any consent
.. .. .. .. .. .. .. .. 2 0
Appointment for hearing of any application
.. .. .. 3 0
Hearing any application ..
.. .. .. .. .. .. 5 0
Filing viva voce evidence on oath of each witness
.. .. 2 0
Filing any document not otherwise provided for
.. .. 2 0
Adoption order, including seal, and filing thereof
.. .. 12 0
Every duplicate order, including seal
.. .. .. .. 2 0
Registering memorandum of discharge, &c., of order
.. 3 0
Summons for witness
.. .. .. .. .. .. .. 2 0
Swearing each witness
.. .. .. .. .. .. .. 2 0
Service of any notice, appointment, summons, order, or other
document: 1s. per mile for one way only from Courthouse.

As witness the hand of His Excellency the Governor,
this thirteenth day of February, one thousand
nine hundred and twelve.

D. BUDDO,
For Minister of Justice.

Warrant appointing Conciliation Commissioner under the
Industrial Conciliation and Arbitration Amendment Act,
1908.

ISLINGTON, Governor.
IN exercise and pursuance of the power and authority
conferred by section twenty-nine of the Industrial
Conciliation and Arbitration Amendment Act, 1908, I,
John Poynder Dickson-Poynder, Baron Islington, the
Governor of the Dominion of New Zealand, do hereby
appoint

PATRICK HALLY

to be a Conciliation Commissioner under and for the
purposes of Part III of the said Act, and to exercise
jurisdiction within the Wellington, Marlborough, Nelson,
and Westland Industrial Districts. Appointment to date
from the twenty-second day of January, one thousand nine
hundred and twelve.

As witness the hand of His Excellency the Governor,
at Wellington, this eighteenth day of January,
one thousand nine hundred and twelve.

J. A. MILLAR,
Minister of Labour.

Warrant appointing Conciliation Commissioner under the
Industrial Conciliation and Arbitration Amendment Act,
1908.

ISLINGTON, Governor.
IN exercise and pursuance of the power and authority
conferred by section twenty-nine of the Industrial
Conciliation and Arbitration Amendment Act, 1908, I,
John Poynder Dickson-Poynder, Baron Islington, the
Governor of the Dominion of New Zealand, do hereby
appoint

THOMAS HARLE GILES

to be a Conciliation Commissioner under and for the
purposes of Part III of the said Act, and to exercise
jurisdiction within the Northern and Taranaki Industrial
Districts. Appointment to date from the twenty-second
day of January, one thousand nine hundred and twelve.

As witness the hand of His Excellency the Governor,
at Wellington, this eighteenth day of January,
one thousand nine hundred and twelve.

J. A. MILLAR,
Minister of Labour.