5174
THE NEW ZEALAND GAZETTE.
[No. 107

ENDORSEMENT.
Dated , 1915.
The Superintendent of Workers’ Dwellings,
and
Purchaser.
Agreement to purchase Worker’s Dwelling,
Settlement.
Section No.
Capital value: £

Form W.D. 2B.
AGREEMENT FOR RENEWABLE LEASE OF WORKER’S DWELLING.
(Under Section 9 of the Workers’ Dwellings Act, 1910.)
MEMORANDUM OF AGREEMENT made this day of
19 , between the Superintendent of Workers’ Dwellings
(hereinafter called “the Superintendent”), on behalf of
His Majesty the King, of the one part, and [Name in full,
address, and occupation], a worker within the meaning of
the Workers’ Dwellings Act, 1910 (hereinafter called “the
lessee”), of the other part.
Subject to the provisions of the said Act and of the regulations thereunder, the Superintendent agrees to grant and the lessee agrees to accept a renewable lease for a term of twenty-one years of (a) [in the case of a dwelling already erected] the worker’s dwelling, being [Specify number, street, and other particulars sufficient to identify the dwelling], as from the day of , 19 ; or (b) a worker’s dwelling to be erected on the land described in the Schedule hereto in accordance with the particulars set out therein, as from a date to be hereafter fixed by the Superintendent [being not later than fourteen days after notice of the date of the completion of the dwelling has been given to the lessee by or on behalf of the Superintendent.]
It is also agreed that the lessee shall pay to the Superintendent aforesaid by payments, at such place as the Superintendent from time to time directs, the sum of per as rent in respect to the said dwelling.
And it is hereby further expressly stipulated and agreed that this agreement is entered into subject to the provisions and conditions relating thereto contained in the Workers’ Dwellings Act, 1910, and the regulations at present in force thereunder, which said provisions and conditions shall be deemed to be contained herein.
The purchaser hereby acknowledges to have received on the execution hereof a copy of the said Act and the regulations thereunder.
In witness whereof the parties hereto have hereunto set their hands the day and year first above written.

Signed by the Superintendent of Workers’ Dwellings in the presence of

Signed by the said in the presence of

SCHEDULE.
Site:—

1. Description and area of section:
   Dwelling:—
2. Number of rooms:
3. Number of departmental design in accordance with which building is to be erected:
4. Capital value:
5. Any other particulars concerning land or building:

Form W.D. 2c.
AGREEMENT FOR WEEKLY [or MONTHLY] TENANCY OF WORKER’S DWELLING.
(Under Section 9 of the Workers’ Dwellings Act, 1910.)
MEMORANDUM OF AGREEMENT made this day of , 19 , between the Superintendent of Workers’ Dwellings (hereinafter called “the Superintendent”), on behalf of His Majesty the King, of the one part, and [Name in full, address, and occupation], a worker within the meaning of the Workers’ Dwellings Act, 1910 (hereinafter called “the tenant”), of the other part.
Subject to the provisions of the said Act and of the regulations thereunder, the Superintendent agrees to let and the tenant agrees to take, on a weekly [or monthly] tenancy at a weekly [or monthly] rent of , payable at such place as the Superintendent from time to time directs, (a) [in the case of a dwelling already erected] the worker’s dwelling, being [Specify number, street, and other particulars sufficient to identify the dwelling], as from the day of , 19 ; or (b) a worker’s dwelling to be erected on the land described in the Schedule hereto in accordance with the particulars set out therein, as from a date to be hereafter fixed by the Superintendent [being not later than fourteen days after notice of the date of the completion of the building has been given to the tenant by or on behalf of the Superintendent].
And it is hereby further expressly stipulated and agreed that this agreement is entered into subject to the provisions and conditions relating thereto contained in the Workers’ Dwellings Act, 1910, and the regulations for the time being in force thereunder, which said provisions and conditions shall be deemed to be contained herein.
In witness whereof the parties hereto have hereunto set their hands the day and year first above written.

Signed by the Superintendent of Workers’ Dwellings in the presence of

Signed by the said in the presence of

SCHEDULE.
Site:—

1. Description and area of section:
   Dwelling:—
2. Number of rooms:
3. Number of departmental design in accordance with which building is to be erected:
4. Capital value:
5. Any other particulars concerning land or building:

Form W.D. 2d.
PROVISIONAL AGREEMENT TO PURCHASE A WORKER’S DWELLING.
To the Superintendent of Workers’ Dwellings on behalf of His Majesty the King.
IN consideration of your acquiring for workers’ dwellings under the powers contained in the Workers’ Dwellings Act, 1910, or any amendment thereof, all that parcel of land situate , and being , I agree, whenever called upon by you so to do, to enter into an agreement to purchase, under the provisions of the said Act, a worker’s dwelling to be erected on that parcel of land, marked on the plan produced to me and signed by me, at a price not exceeding . I herewith hand you the sum of nine pounds, which, together with the fee of one pound already paid, shall be the deposit of ten pounds required by the Act, and I agree that if I shall fail to enter into an agreement for purchase in terms of the said Act, when the cost of the land and dwelling has been ascertained, the said sum of ten pounds shall be absolutely forfeited to you, and you shall be at liberty to recover from me all loss or damages that you may have sustained by reason of my failure to carry out the undertaking on my part herein contained.
Dated this day of , 19 .
Name:
Address:
Occupation:
Witness:

Form W.D. 3A.
CERTIFICATE OF BOARD ENTITLING PURCHASER TO CERTIFICATE OF TITLE FOR WORKER’S DWELLING.
(Under Section 14 of the Workers’ Dwellings Act, 1910.)
THIS is to certify that [Name in full], of [Address], [Occupation], a party to an agreement, dated the day of , 19 , to purchase the worker’s dwelling comprised in Lot and the buildings erected thereon, has paid the full amount payable under that agreement, and that the Board is satisfied that the terms and conditions contained in the said agreement have been duly complied with.
A copy of the said agreement is attached hereto.
Dated at this day of , 19 .

Signed by the Superintendent of Workers’ Dwellings, the day of , 19 .

Form W.D. 4A.
APPLICATION TO TRANSFER INTEREST IN PURCHASE OR LEASE OF WORKER’S DWELLING.
To the Superintendent of Workers’ Dwellings, Wellington.
I, [Name in full], of [Address], hereby apply to transfer to [Name in full], of [Address], [Occupation], my interest in the purchase or lease of the worker’s dwelling situated on Section , Settlement, District, and I propose to sell my interest in the said worker’s dwelling to him