APRIL 30.] THE NEW ZEALAND GAZETTE. 1583

Form No. 9.

APPLICATION FOR A STATE GUARANTEE FOR A LOAN UNDER THE LOCAL BODIES’ LOANS ACT, 1913.
(Where proposal approved by poll of ratepayers.)

Application of [Name of local authority].
Amount of loan :
Purpose for which loan required :
Special-rating district or area :
Date of this application :

To the Superintendent (Advances to Local Authorities Branch), State Advances Office, Wellington.

1. THE above-named local authority hereby applies for a State guarantee for a special loan of £ , in respect of which a preliminary application was approved by the Minister of Finance, as notified by you on the day of , 19 .

2. The terms and conditions of this loan are—
   (a.) The loan is for the purpose of [State purpose].
   (b.) The rate of interest to be per centum per annum.
   (c.) The term to be thirty-three years.
   (d.) The security of the loan is—(i) A special rate in the pound over [Describe special-rating district or area] ; (ii) [State any other security].

3. The proposal to raise the loan has been duly submitted to and approved by the ratepayers of the [Name of special-rating district] as by law required.

4. The notice of intention to raise the loan was duly published in the newspaper, once in each week for four successive weeks—namely, on the , 19 .

5. The notice of the poll of ratepayers was published in the newspaper on the following days , and the proposal to raise the loan was duly carried at that poll taken on the day of , 19 . Notice of the result of the poll was published in the New Zealand Gazette of the , 19 (page ), and also in the newspaper of the day of , 19 .

6. A copy of the voting-paper used at the poll is attached hereto, marked with my initials.

7. 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.

8. 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.

9. 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.

10. 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 this special-rating area).

[11. The special roll was prepared in accordance with section 3 of the Local Bodies’ Loans Act, 1913, and deposited for public inspection at the office of the [Name of local authority] from to ; and public notice thereof was published in the newspaper, on the day of , 19 , and no valid objection was lodged against the said roll.]*

12. The financial position of the Council, , is as shown by the attached statement.

13. Draft forms of debenture and coupons are hereto attached.

14. The amount payable to the sinking fund is £ .

A. B.,
Mayor [or Chairman].

• Special roll and tracing only required where special-rating area is not a legal subdivision of a district.

DECLARATION VERIFYING APPLICATION FOR STATE GUARANTEE.

I, A. B., Mayor [or Chairman] 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 me—
C. D.,
Justice of the Peace [or Solicitor].

THIRD SCHEDULE.

Form No. A.

NOTICE ON MERGER OF WHOLE OF AREA OVER WHICH SPECIAL RATE MADE AS SECURITY FOR LOAN.

To [Name of local authority or Minister of Finance].

In pursuance of the provisions of section 73 of the Local Bodies’ Loans Act, 1913, and of the regulations thereunder, I hereby give notice that the area hereunder described, being formerly part of the