Aug. 27.] THE NEW ZEALAND GAZETTE. 3275

Form No. 3.

DECLARATION IN SUPPORT OF APPLICATION FOR CONFIRMATION.

(Regulation No. 24.)

The Native Land Act, 1909 : Section 218.

In the matter of an application made on the day of , 19 , to the Maori Land Board of the Maori Land District [or to the Native Land Court] for the confirmation of an instrument of alienation of [part of] the land known as , made between [Naming the parties thereto, or such of them as are sufficient to identify the instrument], and executed on [State the day or days of execution].

I, , of , do solemnly and sincerely declare—

1. That I am one of the parties to the above-mentioned instrument of alienation.
2. That the said instrument was duly executed by the Natives whose signatures appear thereon on the day or days specified in that behalf in the said instrument.
3. That on the date of the execution of the said instrument by any party thereto no party acquiring any interest under that instrument was precluded by the provisions of Part XII of the Native Land Act, 1909, or sections 70 to 81 (inclusive) of the Native Land Amendment Act, 1913, from acquiring that interest.
4. That I am over the age of seventeen years.

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

[Signature.]

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

[N.B.—Native Land Amendment Act, 1913, section 72 (1): “It shall not be lawful for any person to acquire any Native freehold land as the beneficial owner, lessee, or sublessee thereof (whether at law or in equity, and whether solely or jointly or in common with any other person) if the land so acquired by him, together with all other land (whether Native, European, or Crown land) owned, held, or occupied by him under any tenure of more than one year and six months’ duration (whether at law or in equity, and whether severally or jointly or in common with any other person), would exceed a total area of five thousand acres, calculated in manner provided by section ninety-seven of the Land Act, 1908, and sections one hundred and ninety-four to one hundred and ninety-eight (inclusive) of the principal Act.”]

[Where the declaration is made on behalf of a body corporate the foregoing form is to be used with such modifications as are necessary.]

Form No. 4.

CERTIFICATE OF CONFIRMATION.

(Regulation No. 26.)

The Native Land Act, 1909 : Section 219.

At a sitting of the , held at , the day of , 19 .

WHEREAS the said Board [or Court], after due inquiry, is satisfied that the alienation purporting to be effected by the within deed has been effected in all respects in accordance with the law in force at the time of the execution thereof, and as to all matters upon which the said Board [or Court] is by law required to be satisfied, the said Board [or Court] hereby confirms the alienation (so far as it affects the shares of those persons whose names are written in the Schedule hereto) purporting to be effected by the within deed.

Given under the seal of the said Board [or Court] at , this day of , 19 , in the presence of—
, President.
, Member.
[or Judge].

SCHEDULE.

Form No. 5 (to be lodged with Form No. 2).

APPLICATION FOR CONSENT OF THE GOVERNOR IN COUNCIL UNDER SECTION 230.

(Regulation No. 29.)

The Native Land Act, 1909.

To the Maori Land Board for the Maori Land District.

[Or To the Native Land Court.]

I, , hereby apply under section 230 of the Native Land Act, 1909, for the consent of the Governor in Council to the confirmation by the Board [or Court] of the instrument of alienation by way of security, particulars whereof are set out hereunder :—

Mortgagors : .
Mortgagees : .
Name of land : .
Area of land : .
Amount of mortgage : .
Government valuation : Amount— . Date— .
Dated at , this day of , 19 .

[Signature of Applicant.]

F