Dec. 2.] THE NEW ZEALAND GAZETTE. 3955

Measurements of the boundaries of the section or lot of land on which the brewery is situate, also block plan of such section or lot of land as per plan attached hereto : Description of all buildings on the brewery premises, material of which constructed, and description of wall, fence, or other outside boundary of premises : Statement of the title under which the premises on which the brewery is situated are held, and the name or names of the owner or owners thereof :

Capacity of Each, and how marked.

Number of mash-tuns .. .. ..
Number of wort-boilers .. .. ..
Number of fermenting gyles or vessels ..
Number of other permanent vessels—viz.,
Manner of boiling worts, whether by direct action of fire or by steam :
Average number of brewings per month :
Total quantity of beer made, and sold or removed from the brewery, during the year immediately preceding the date of this application :

I, , of , in the County [or Borough] of , [partner, or director, or manager, or secretary] of the above-named firm [or corporate body] declare that the several statements set forth in the foregoing application are true and correct in the several particulars thereof.

[Signature.]

Declared before me, at , this day of , 19 .

Collector [or Officer of Customs, or Postmaster, or Solicitor, or Justice of the Peace.]

[Form No. 2.]

BREWER’S LICENSE.

No......

County [or Borough] of .

WHEREAS , of , has paid into my office the sum of pounds, in accordance with the provisions of the Finance Act, 1915, I do hereby license the said to carry on the business of a brewer, and to sell, in quantities of not less than 2 gallons, beer, ale, or porter made at his brewery at , from the day of , 19 , to the 31st day of December, 19 .

Dated at this day of , 19 .

Collector of Customs.

[Form No. 3.]

BREWER’S BOND.

Know all men by these presents that we [Name, residence, and occupation, in words at length, of the brewer] (hereinafter referred to as “the brewer”), and [Names, residences, and occupations, in words at length of two sureties], are held and firmly bound unto His Majesty the King in the sum of [Amount of penalty in words at length] pounds sterling, to be paid to His Majesty the King, his heirs and successors ; to which payment well and truly to be made we bind ourselves, and every of us, jointly and severally for and in the whole, our and every of our heirs, executors, administrators, successors, and assigns, firmly by these presents. Sealed with our seals. Dated this [Date of first signature in words at length] day of , in the year of our Lord one thousand nine hundred and .

WHEREAS the brewer proposes to be engaged in the business of brewing within the District of , to wit, situate at Street, in the of , in the County of , and has proposed to enter into these presents pursuant to Part III of the Finance Act, 1915 (hereinafter referred to as “the said Act”).

Now, the condition of this obligation is such that if the brewer shall duly and punctually from time to time account for all beer made in his brewery, and shall pay, or cause to be paid, as provided by law, the duty required by law on all beer, as the same is defined by the said Act, and made by or for him, or in his brewery ; and shall keep true and exact account, as provided for in the said Act, of all materials purchased, made, and used, of all beer brewed and delivered, and shall in all other respects faithfully comply, without fraud or evasion, with all the requirements of all laws and regulations relating to the manufacture and sale of beer, then this obligation shall be void, otherwise it shall remain in full force and virtue.

Signed, sealed, and delivered by the above-named [Names of principal and sureties in words at length] in the presence of .

NOTE.—A seal to be affixed for each party, and the bond to be signed in the presence of two witnesses, who must sign their names, adding separately in their own handwriting their residences and occupations. An attestation must be added for each separate witnessing.

[Form No. 4.]

BREWER’S ENTRY.

Place:............

........day of........19 .

Name of Brewery: ............

Brewer [or Authorized Agent].

ACCOUNT of beer entered for duty from , 19 , to , 19 .

I,........, do hereby declare that the particulars contained in this entry are true and correctly stated in every respect.

Brewer [or Authorized Agent].

Certified correct as per brewer’s book:

Officer of Customs.

To the . No. .

Collector.

[Form No. 5.]

BREWER’S BOOK.

PURSUANT to the Finance Act, 1915, I, , of , declare that to the best of my knowledge and belief the entries and particulars herein contained are truly and correctly stated in every particular, and that I have no knowledge of any matter or thing required by the aforesaid Act to be stated in the said entries having been omitted therefrom.

[To be signed by the brewer if the entries in the book were not made by him.]

Declared at this day of , 19 , before me—

Collector of Customs [or Officer of Customs, or Justice of the Peace, or Postmaster, or Solicitor, or Notary Public].