2746
THE NEW ZEALAND GAZETTE,
[No. 93

Form 49 (Reg. 77).

Under “The Mining Act, 1908.”

APPLICATION TO REGISTER A MINING PRIVILEGE HELD OTHERWISE THAN UNDER LICENSE.

To the Mining Registrar of the Mining District,
at

PURSUANT to “The Mining Act, 1908,” I, A. B. [Full name, residence, and occupation], being the lawful holder of the unregistered mining privilege described in the Schedule hereto, do hereby make application to register the same, and I hereby declare as follows:—

(a.) That I have duly observed all the provisions of the said Act relating to the said privilege, and that the title to the same is occupation under miner’s right;

(b.) That I verily believe I am entitled to the grant of this application.

Date and number of miner’s right:

Address for service:

Dated at , this day of , 19 .

SCHEDULE.

[Set out name, locality, and area of the mining privilege with sufficient particularity for identification.]

[Signature of applicant, &c.]

—

Form 50 (Reg. 77).

Under “The Mining Act, 1908.”

CERTIFICATE OF REGISTRATION OF MINING PRIVILEGE HELD OTHERWISE THAN UNDER LICENSE.

PURSUANT to application in that behalf made by A. B. [Full name, residence, and occupation], the lawful holder of the mining privilege described in the Schedule hereto, I, Mining Registrar of the Mining District at , do hereby certify that I have this day registered such mining privilege as No. .

In witness whereof I have hereunto signed my name this day of , 19 .

SCHEDULE.

[Set out name, locality, and area of the mining privilege as in the application.]

, Mining Registrar.

—

Form 51 (Reg. 78).

Under “The Mining Act, 1908.”

APPLICATION TO REGISTER LIEN.

To the Mining Registrar of the Mining District,
at

THE undersigned [Full name, residence, and occupation] hereby applies to register a lien against the mining privilege[s] specified in the First Schedule hereto, for £ , in respect of moneys due to him as wages-man [or subcontractor, or contractor, or partner, as the case may be], particulars whereof are specified in the Second Schedule hereto.

Address for service:

Dated at , this day of , 19 .

FIRST SCHEDULE.

[Describe the name, situation, and registered number of each mining privilege, and the name of the holder, and also the equitable owner (if any).]

SECOND SCHEDULE.

[Set out briefly but clearly the particulars of the debt, giving, in the case of wages, the name of the employer, the period, place, and nature of the employment, and the rate and amount of the wages, and in any other case the corresponding particulars as to names, dates, amounts, &c.]

[Signature of applicant, &c.]

Form 52 (Reg. 78).

Under “The Mining Act, 1908.”

NOTICE TO OWNER OF MINING PRIVILEGE AGAINST WHICH A LIEN HAS BEEN REGISTERED.

To A. B. [Full name, residence, and occupation], the holder or equitable owner of the mining privilege[s] set out in the Schedule hereto.

TAKE notice that C. D. [Full name, residence, and occupation] has this day registered as No. a lien against the undermentioned mining privilege[s] for the sum of £ due to him as wages-man [subcontractor, contractor, or partner, as the case may be].

SCHEDULE.

Dated at , this day of , 19 .
, Clerk of Warden’s Court.

—

Form 53 (Reg. 78).

Under “The Mining Act, 1908.”

DISCHARGE OF LIEN.

Registered number of lien:

Office of registration:

Date of registration:

Amount of lien: £ .

Name and locality of mining privilege affected, its registered number (if any), and the name of its holder:

THE above-mentioned lien is hereby declared to be discharged, by [Set out mode of discharge—e.g., satisfaction, withdrawal, order of the Warden, or as the case may be].

Dated at , this day of , 19 .

A. B. (Lienee)

[If discharge is by him; or, if discharge is by order of the Warden, then—

C. D., Warden.]

[If discharge is by Lienee, his signature should be attested thus—

Signed by the said A. B., as Lienee, in the presence of E. F. (adding occupation and residence).]

[If discharge is by payment into Court, or by receipt of the workman duly filed, then—

G. H., Registrar].

—

Form 54 (Reg. 87).

NUMERICAL INDEX OF REGISTRATIONS AT , IN THE MINING DISTRICT.