Nov. 20.] THE NEW ZEALAND GAZETTE. 3545

New Zealand Inscribed Stock Act, 1917.—Prescribing Forms to be used.

The Treasury,
Wellington, 20th November, 1919.

NOTICE is hereby given that the Minister of Finance has prescribed the following forms to be used under the New Zealand Inscribed Stock Act, 1917.

G. F. C. CAMPBELL,
Registrar of New Zealand Inscribed Stock.

FIRST SCHEDULE.
INSCRIPTION REGISTER.

SECOND SCHEDULE.
FORM OF APPLICATION FOR DOMINION OF NEW ZEALAND -PER-CENT. INSCRIBED STOCK.

(Under the New Zealand Inscribed Stock Act, 1917.)

To the Registrar of New Zealand Inscribed Stock, The Treasury, Wellington.

I [We] hereby apply for pounds of Dominion of New Zealand -per-cent. inscribed stock in accordance with the prospectus.

The sum of £ , being the amount of the required lodgment, is enclosed herewith.

Signature :
Name of applicant (in full) :
Address :

Date : , 19 .

NOTE.—This form may be lodged at any postal money-order office or at any branch of any bank, or may be forwarded to The Treasury, Wellington.

Any default in payment of an instalment at due date will render previous payments liable to forfeiture.

(To be filled in by Bank or Postal Officer receiving application.)

† Bank receipt herewith . . . . . . . . £
† Amount entered in Postmaster’s statement of loan receipts . . . . . . . . £

For and on behalf of the Government of New Zealand—

(Date-stamp.) [Signature of Receiving Officer.] Office.

† Strike out line not required.

(To be filled in by the Treasury.)

Credit voucher prepared (1st instalment) Vr. No. £
" (2nd " ) " £
" (3rd " ) " £
" (4th " ) " £

Stock “Inscription” issued : No.

Posted : , 19 .

THIRD SCHEDULE.
APPLICATION FOR A STOCK CERTIFICATE. , 19 .

To the Registrar of New Zealand Inscribed Stock, The Treasury, Wellington.

In accordance with section 10 of the New Zealand Inscribed Stock Act, 1917, I [we], , of , being the holder of New Zealand inscribed stock to the amount of pounds, do hereby make application for a Stock Certificate in favour of bearer for the sum of pounds, to be issued to me [us] in accordance with and subject to the provisions of the New Zealand Inscribed Stock Act, 1917.

The prescribed fee of is enclosed herewith.

Inscription No. . Date of maturity : .

[Signature.]
[Address.]

FOURTH SCHEDULE.
STOCK CERTIFICATE.

No. £

New Zealand Inscribed Stock.

(Issued under authority of the New Zealand Inscribed Stock Act, 1917.)

The bearer of this Stock Certificate will be entitled to payment of the sum of pounds sterling upon presentation and surrender hereof at The Treasury, at Wellington, New Zealand, on the , together with such interest, computed at the rate of pounds shillings sterling per centum per annum, as may be found to be unpaid on the before-mentioned date, in accordance with the endorsements of interest payments made hereon.

Interest hereon at the rate of pounds shillings sterling per centum per annum is payable half-yearly on the and in each year, at The Treasury, Wellington, or at any post-office money-order office within the Dominion.

(The amount of interest paid is to be endorsed on the back hereof by the person making such payment.)

Dated at the office of the Registrar of Inscribed Stock, Wellington, , 19 .

. . . . . . . . . . . . .

Registrar.

Countersigned— , Controller and Auditor-General.

Entd: folio .

FIFTH SCHEDULE.
STOCK CERTIFICATES.

Particulars to be entered in Inscription Register.

Stock Certificate No. .
Amount .
Issued , 19 .
Treasury Record No. .

SIXTH SCHEDULE.
APPLICATION TO INSCRIBE AMOUNT OF STOCK CERTIFICATE. , 19 .

To the Registrar of New Zealand Inscribed Stock, The Treasury, Wellington.

In accordance with section 11 of the New Zealand Inscribed Stock Act, 1917, I [we] hereby make application to have the amount of Stock Certificate No. , £ , inscribed in the Inscription Ledger in my [our] name.

The fee ( ) payable, and Stock Certificate are enclosed herewith.

[Signature.]
[Witness.]

SEVENTH SCHEDULE.
APPLICATION FOR CERTIFICATE OF TITLE. , 19 .

To the Registrar of New Zealand Inscribed Stock, The Treasury, Wellington,

In accordance with the provisions of section 12 of the New Zealand Inscribed Stock Act, 1917, I [we] hereby make application for a certificate of title relating to the inscribed stock of which I am [we are] the holder.

The fee ( ) payable for such certificate is enclosed herewith.

Inscription No. . Date of maturity : .

[Signature.]
[Address.]

EIGHTH SCHEDULE.
New Zealand Inscribed Stock.

(Under the New Zealand Inscribed Stock Act, 1917.)

CERTIFICATE OF TITLE.

£ Inscripton No.

Office of the Registrar of Inscribed Stock, Wellington, , 19 .

This is to certify that , of , is the registered owner of pounds of -per-cent. New Zealand inscribed stock, maturing , which amount has been duly inscribed in the books of The Treasury under the name and address mentioned above.

This certificate is conclusive evidence of the ownership of the stock to which it relates, and is proof that no Stock Certificate is outstanding in respect of that stock.