Dec. 16. THE NEW ZEALAND GAZETTE. 4045

Question. Answer.

1. What is the age of the applicant ?
2. What land does the applicant hold or have an interest in ? Give particulars in full, stating tenure and value.
3. If applicant is married, what land (if any) does his wife hold or have an interest in ? Give particulars in full, stating tenure and value.
4. What capital has the applicant for working and improving the land ? State—
   (a.) Amount of cash ..
   (b.) Value of stock ..
   (c.) Implements or other property.
5. What financial assistance can the applicant procure if required ? State amount, and from whom obtainable, and furnish written guarantee.
6. Has the applicant since the 11th November, 1913 — (1) Disposed of any lease or license of Crown land or settlement land ? or (2) Has his interest under any lease or license been declared forfeited ?
7. Give generally the applicant’s experience of farming.
8. State what use is to be made of the land pending the return of the applicant to the Dominion.
9. State under what authority you make this application as agent.

[Form No. 2.

DECLARATION UNDER THE LAND ACT, 1908.

Declaration of an Agent on applying for Land under Part III of the Land Act, 1908 (Section 24 of the Land Laws Amendment Act, 1915).

I, [Name in full], of [Address and occupation], do solemnly and sincerely declare—

1. That I am the duly authorized agent of the within-mentioned , who is a member of an Expeditionary Force on military service beyond New Zealand.
2. That the said is of the age of seventeen years and upwards.
3. That the said is, subject to the provisions of the Land Act, 1908, applying for the land described in the accompanying application solely for his own use and benefit on his return to the Dominion, and not directly or indirectly for the use or benefit of any other person or persons whomsoever.
4. That, including the area of the largest allotment applied for, the said is not the holder, owner, or occupier under any tenure of more than one year’s duration, either severally or jointly or in common with any other person or persons, of any land anywhere in New Zealand exceeding on the whole 5,000 acres of land computed as follows—(a) Every acre of first-class land is reckoned as 7½ acres; (b) every acre of second-class land is reckoned as 2½ acres; (c) every acre of third-class land is reckoned as 1 acre.
5. That my answers to the questions contained in the accompanying application are true and correct in every particular.
   And I make this solemn declaration for and on behalf of the said conscientiously believing the same to be true, and by virtue of the Justices of the Peace Act, 1908.

[Signature of Agent],

For and on behalf of the within-mentioned .

Declared at this day of , 191 , before me— , a Justice of the Peace for New Zealand [or Solicitor, or Notary Public].

[Form No. 3.

APPLICATION UNDER THE LAND FOR SETTLEMENTS ACT, 1908.

Application No. .

Application for Renewable Lease of Settlement Land.

To the Commissioner of Crown Lands, .

I, , agent for , who is a member of the Expeditionary Force, hereby apply for the following sections under the provisions of the Land for Settlements

Act, 1908, and make the following replies to the questions on the back hereof :—

Full name of applicant :
Number of Expeditionary Force with which applicant is serving :
Number of applicant’s company :
Regimental number :
Occupation of applicant prior to enlisting :
Address of applicant prior to enlisting :
Full name of agent :
Address of agent :
Occupation of agent :
Relationship (if any) existing between applicant and agent :

Received on , 191 , at .
, Commissioner of Crown Lands.

Question. Answer.

1. What is the age of the applicant ?
2. What land does the applicant hold or have an interest in ? Give particulars in full, stating tenure and value.
3. If applicant is married, what land (if any) does his wife hold or have an interest in ? Give particulars in full, stating tenure and value.
4. What capital has the applicant for working and improving the land ? State—
   (a.) Amount of cash ..
   (b.) Value of stock ..
   (c.) Implements or other property.
5. What financial assistance can the applicant procure if required ? State amount, and from whom obtainable, and furnish written guarantee.
6. Has the applicant since the 11th November, 1913 — (1) Disposed of any lease or license of Crown land or settlement land ? or (2) Has his interest under any lease or license been declared forfeited ?
7. Give generally the applicant’s experience of farming.
8. State what use is to be made of the land pending the return of the applicant to the Dominion.
9. State under what authority you make this application as agent.

[Form No. 4.

DECLARATION UNDER THE LAND FOR SETTLEMENTS ACT, 1908.

Declaration of an Agent on applying for a Renewable Lease of Settlement Land under the Land for Settlements Act, 1908 (Section 24 of the Land Laws Amendment Act, 1915).

I, [Name in full], of [Address and occupation], do solemnly and sincerely declare—

1. That I am the duly authorized agent of the within-mentioned , who is a member of an Expeditionary Force on military service beyond New Zealand.
2. That the said is of the age of twenty-one years and upwards.
3. That the said is, subject to the provisions of the Land for Settlements Act, 1908, and the regulations made thereunder, applying for a renewable lease of the allotment described in the foregoing application solely for his own use and benefit on his return to the Dominion, and not directly or indirectly for the use or benefit of any other person or persons whomsoever.
4. That the said is not, directly or indirectly, the owner, tenant, or occupier of any land whatsoever under the Land for Settlements Act, 1908, or any former Land for Settlements Act.