Jan. 14.] THE NEW ZEALAND GAZETTE. 165

RETURN of the Land and Mortgages of [Name in full and postal address], made in pursuance of the Land and Income Assessment Act, 1908, and its amendments, and the Regulations thereunder, so far as respects all Land owned or leased by the Company, and all Mortgages held by the Company, as at noon on the 31st Day of March, 19 .

Ordinary Tax.

Unimproved value of land owned by the company (particulars on page 3 hereof) .. .. .. £
Add amount owing to the company—
(a.) On registered mortgage of land ..£
(b.) Unpaid purchase-money for land sold (particulars on page 2 hereof) ..

Total .. .. ..
Deduct amount owing by the company—
(a.) On registered mortgage of land ..£
(b.) Unpaid purchase-money due to the vendor for land bought (particulars on page 2 hereof) .. ..

Balance .. .. ..£

Graduated Tax.

Unimproved value of land owned by the company (particulars on page 3 hereof) .. .. ..£

I, , the duly appointed public officer of the above-named company, do solemnly and sincerely declare that this return contains true and accurate details of the several matters and things set forth as at noon on the 31st day of March, 19 . And I make this declaration under the provisions of the Land and Income Assessment Act, 1908, and its amendments.

Dated this day of , 19 .
[Usual signature.]

Particulars of Money owing to the Company as at Noon on the 31st March, 19 —(a) Secured on Registered Mortgage; (b) in respect of Unpaid Purchase-money for Land sold.

Particulars of Money owing by the Company as at Noon on the 31st March, 19 —(a) Secured on Registered Mortgage; (b) in respect of Unpaid Purchase-money due to the Vendor for Land bought.

Particulars of Land owned by or leased to the Company as at Noon on the 31st March, 19 .

Sales of Land.

6. RETURN OF INCOME BY PERSON OR FIRM.

The Land and Income Assessment Act, 1908, and its amendments.

IN pursuance of the above Acts and of the regulations made thereunder, every person, whether liable to taxation under the said Acts or not, in receipt of income within the meaning of the said Acts is required to fill up the following return as far as is applicable to his particular case, and deliver the same at, or forward it by post to, the office of the Commissioner of Taxes, Wellington, on or before the day of , 19 .

, Commissioner of Taxes.

RETURN of the Income of [Name in full, occupation, and postal address], made in pursuance of the Land and Income Assessment Act, 1908, and its amendments, and the Regulations thereunder.

Income derived during the Year ending 31st March, 19 .

Gross Income from Business.

Amount. £

1. From the trade, business, manufacture, or concern of , carried on by me at (as per details shown on page 3) .. ..
2. From interest on money deposited or lodged with any bank, society, company, firm, or person, and from interest on unregistered mortgages, bonds, debentures, or like instruments .. ..
3. From annuities or other annual payments ..
4. From lands occupied for pastoral purposes ..
5. From mining .. .. ..
6. From dividends paid or profits credited by any building society .. .. ..
7. From any other source [State source] .. ..

Total .. .. ..

Deductions (as per details shown on page 3).

Losses, outgoings, and expenses incurred in the production of the gross income stated above ..

Net income derived from business ..£

Gross Income from Employment or Emolument.

Amount. £

1. From the profession, employment, or vocation of .. ..
2. From salary, wages, allowances, bonus, pension, stipend, fees, charge, or annuity of any kind ..
3. From commissions or share of profits by way of or in lieu of salary .. .. ..
4. From any other source [State source] .. ..

Total: .. .. ..

Deductions (as per details shown on page 3).

Losses, outgoings, and expenses incurred in the production of the gross income stated above ..

Net income derived from employment or emolument .. .. .. ..£

I claim deduction on account of insurance as per particulars on page 4 .. .. ..£
I claim deduction on account of children as per particulars on page 4 .. .. ..£

I, the person making the foregoing return, do solemnly and sincerely declare that it contains true and accurate details of the several matters and things set forth. And I make this declaration under the provisions of the Land and Income Assessment Act, 1908, and its amendments.

Dated this day of , 19 .
[Usual signature.]