May 17.] THE NEW ZEALAND GAZETTE. 2055

23. (1.) The return required by section 157 of the said Act
    to be made by employers of all persons employed by them
    may be made in the form No. 11 in the Schedule hereto.
    (2.) In the case of Government Departments such return
    may be made by the administrative head of the Department,
    in the case of a company by the secretary or a director, and
    in the case of a local authority by the Chairman or the Clerk.
24. The return of interest paid by banking and other
    corporations, institutions, and persons required to be made
    by section 158 of the said Act may be made in the form
    No. 12 in the Schedule hereto.
25. The return required by section 159 of the said Act to
    be made by companies and by local and public authorities
    relative to debentures issued by them may be in the form
    No. 13 in the Schedule hereto.
26. Every application to the Commissioner to exempt the
    seller of any land from the operation of the provisions of
    section 68 of the said Act shall be supported by a statutory
    declaration in the form No. 14 in the Schedule hereto.
27. Every applicant for special exemption pursuant to
    section 50 of the said Act shall, in support of such application,
    furnish to the Commissioner the information indicated on the
    form No. 15 in the Schedule hereto, and such further informa-
    tion as the Commissioner may require.
28. (1.) The security that may be required of a non-
    resident trader or non-resident agent, pursuant to section 106
    of the said Act, may be by way of bond in the form No. 16
    in the Schedule hereto.
    (2.) Where the security required is by way of deposit the
    Commissioner shall give a receipt therefor in the form No. 17
    in the Schedule hereto.
29. Every warrant under section 105 of the said Act issued
    to a non-resident agent and authorizing him to act as agent
    shall be in the form No. 18 in the Schedule hereto; and
    every warrant under the said section issued to a non-resident
    trader and authorizing him to carry on business shall be in the
    form No. 19 in the said Schedule.

APPLICATION OF REGULATIONS.

30. These regulations, so far as they relate to income-tax,
    shall extend and apply to income derived during the year
    ending the 31st day of March, 1916; and, so far as they
    relate to land-tax, shall extend and apply to all land owned
    at noon on the 31st day of March, 1916.

SCHEDULE.

FORM No. 1.

OATH OF FIDELITY AND SECRECY

To be taken and subscribed by all persons appointed or
employed under the Land and Income Tax Act, 1916.

I, , of , do hereby swear that I will truly and
faithfully, according to the best of my knowledge and skill,
perform the duties imposed on or required of me under or for
the purposes of the Land and Income Tax Act, 1916, or under
or for the purposes of any other Act imposing taxes or duties
payable to the Crown, or relating to the imposition of taxa-
tion; and I do further swear that I will not, without lawful
authority, communicate to any person any matter or thing
coming to my knowledge in the performance of my duties,
except for the purpose of carrying into effect the Land and
Income Tax Act or other Act as aforesaid. So help me God!
[Signature.]

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

Commissioner of Taxes [or Deputy Commissioner of Taxes, or Justice of the Peace.]

FORM No. 2.

The Land and Income Tax Act, 1916.

RETURN OF LAND

Owned or held under lease as at Noon on the 31st day of
March, 19 , by

Surname. Christian Name in full.

Occupation.

Postal address (where notices, &c., may be sent or served).

NOTE.—Before filling in this form please read the instructions on the back.

(a.) When land held jointly (whether as joint tenancy or
tenancy in common), state (here) the names and
addresses of all the joint owners and the interest
which each owner has in the land. State also if
any owner is an absentee.

(b.) If the land is held by a firm or partnership, state (here)
the name and address of each partner and his share
in the partnership property, and under “Surname”
(above) give the name of the firm or partnership.
State also if any partner is an absentee.

(c.) If the land is held by a company, state (here) the name
and address of the secretary or a director of the
company, and under “Surname” (above) give the
name of the company.

(d.) If the land is held by a deceased person’s estate or other
trust, state (here) the names and addresses of the
beneficiaries, and under “Surname” (above) give
the name of the estate or other trust. State also
which beneficiaries (if any) are absentees.

(e.) If the land is held by an association, club, council, society,
union, institution, or other body, state (here) the
name and address of secretary, and under “Sur-
name” (above) the name of the association, club, &c.

PART 1.

Amounts owing by the Taxpayer and secured on the Land by
Registered Mortgage or owing under an Agreement to
purchase.

NOTE.—Unregistered loans or unregistered overdrafts
should not be entered.

PART 2.

Particulars as to other Charges on Land (e.g., Annuities or
Rent Charges).

PART 3.

Particulars of the Land owned or leased.

NOTE.—A separate line should be used for each parcel of
land.

LAND HELD IN FREEHOLD.