Jan. 14.] THE NEW ZEALAND GAZETTE. 171

Statement of Gross Income and Deductions therefrom for the Period from to , 19 .

Gross takings:—

Gross income .. .. £

Deductions from gross income:—
Salaries and wages (not to include any sums drawn by proprietors) ..
Rent and lighting ..
Fire insurance (premiums on scenery, properties, and plant only) ..
Repairs of scenery, properties, or plant (not to include additions or improvements to scenery, properties, or plant, nor any depreciation) ..
Travelling-expenses, incurred in New Zealand only ..
Printing, stationery, and advertising ..
Petty expenses, incurred for the business and in New Zealand only (not to include donations, gratuities, nor subscriptions) ..
Other items (to be specified):—

Total deductions .. .. £

Net income .. .. £

19. RETURN OF INCOME BY COMPANY ENGAGED IN SHIPPING.
    The Land and Income Assessment Act, 1908, and its amendments.

In pursuance of the above Acts and of the regulations made thereunder, every company engaged in shipping 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 its 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 of company in full 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 , as per details shown within: £

I, , the duly appointed public officer of the above-named company, do solemnly and sincerely declare that the foregoing return is true and accurate in every particular, and that the copy of the balance-sheet and profit and loss account hereto attached is a true copy of the balance-sheet and profit and loss account of the said company issued to shareholders, or prepared for issue, last prior to the date of this return. 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.]

Return as Agent for Debenture-holders [as in Form 9].

I claim to deduct from net income, &c. [as in Form 6].

Return of Persons resident in New Zealand in the Service or Employ of the Company [as in Form 6].

Return of Directors, Auditors, and Others resident in New Zealand [as in Form 9].

Return by Company having its Head Office in New Zealand— Statement of Gross Income and Deductions therefrom for the Year ending 19 .

Amount. Total.
£ £

Gross income—

Total gross income.. .. £

Deductions from Gross Income.

Salaries and wages .. ..
Rent (include only rent of premises or portion of premises used exclusively for the purposes of the business; not to include rental value of premises owned by taxpayer) .. ..
Rates on business premises or portion of premises used exclusively for the purposes of the business (not to include payments for land-tax or income-tax) ..
Fire and marine insurance ..
Interest, exchange, and discounts allowed, less amounts received (not to include interest on mortgages) ..
Printing, stationery, advertising, stamps, and telegrams ..
Travelling-expenses, incurred in the business only .. ..
Repairs or maintenance (not to include additions or improvements to property or plant, nor any depreciation) ..
Petty expenses, incurred in the business only (not to include donations, gratuities, nor subscriptions) .. ..
Bad debts (to include those proved to be bad during the year and actually written off the books as bad and irrecoverable, and no others) .. ..
Other items—

Total deductions .. ..

Net income .. .. £

Return by Company having its Head Office beyond New Zealand.

Total .. .. £

20. RETURN OF INCOME BY OWNER OR CHARTERER OF SHIPPING RESIDENT BEYOND NEW ZEALAND.
    The Land and Income Assessment Act, 1908, and its amendments.

Name of principal (owner or charterer): .
Address: For year ending , 19 .

This form, when completed, must be forwarded to Tax Department direct.

Dated at , this day of , 19 .
[Signature of Agent.]
[OFFICE STAMP.]

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