Mar. 30.] THE NEW ZEALAND GAZETTE. 777

THE SCHEDULE ABOVE REFERRED TO.

ALL that parcel of land, containing by admeasurement
, and being
———

FORM No. 22.

DECLARATION AND INFORMATION REQUIRED IN SUPPORT OF
AN APPLICATION FOR ADDITIONAL EXEMPTION UNDER
SECTION 5 OR 6 OF THE FINANCE ACT, 1917.

Name of Applicant [Surname, Christian name, and address].

Question.

Answer.

1. What is your present age ? .. .. ..
2. Are you married or single, widow or widower ?..
3. What is your total annual income from all
   sources ?
4. Are you entirely dependent upon the above
   income for your support ? .. ..
5. Do you receive any monetary assistance from
   relatives or others; and, if so, how much ?
   Have you included this amount in the total
   income stated under answer number 2 ? ..
6. What are the respective ages of those dependent
   on you for support, if any ? [State if wholly
   or partially dependent; and, if the latter, the
   extent of dependence] .. .. ..
7. Are you incapacitated by any cause from increas-
   ing your income ? If so, state cause ..
8. If the premises you occupy are owned by yourself,
   what is the annual letting value of same ? ..

I, the person replying to the foregoing questions, do
solemnly and sincerely declare that the answers written above
are true and correct and contain all the information known
to me in connection with the matters inquired into, and I
make this declaration under the provisions of the Land and
Income Tax Act, 1916, and its amendments.

Signed at , this day of , 19 .
[Usual signature.]

———

FORM No. 23.

BOND.

The Land and Income Tax Act, 1916.

Know all men by these presents that I , of
(taxpayer), trading under the style and title of
and , of , and* , of
(sureties), are held and firmly bound unto our Sovereign
Lord King George the Fifth in the sum of sterling,
to be paid to our said Lord the King, his heirs and succes-
sors ; to which payment well and truly to be made we bind
ourselves and every of us, jointly and severally, for and
in the whole, our and every of our heirs, executors, and
administrators, firmly by these presents. Sealed with our
seals. Dated this† day of , one thousand
nine hundred and .

WHEREAS by the Land and Income Tax Act, 1916, it is pro-
vided that the Commissioner of Taxes may at any time and
from time to time require any non-resident trader or non-
resident agent to give security by way of bond, deposit, or
otherwise to the satisfaction of the Commissioner for the
payment of any income-tax which may become payable by
him ; and whereas it appears that the said hath pro-
posed to give the security of these presents for the due payment
of all income-tax which may become payable by him, and the
said Commissioner has agreed to accept such security : Now,
the condition of the above-written bond or obligation is such
that if the said shall, upon demand, make to the said
Commissioner such returns or statements as he (the said
Commissioner) may from time to time require, and shall also
pay to the said Commissioner all income-tax which under
the provisions of the said-recited Act and its amendments
or the regulations thereunder may be lawfully assessed or
levied upon him, then the above-written bond or obligation
shall be void, but otherwise shall be and remain in full force
and virtue.

[L.S.]
[L.S.]
[L.S.]

Signed, sealed, and delivered by the above-named
in the presence of .

• Names, residences and occupations, in words at length, of taxpayer
  and of two sureties.
  † Date of first signature in words at length.

———

FORM No. 24.

RECEIPT FOR DEPOSIT.

The Land and Income Tax Act, 1916.

£
RECEIVED from , of , the sum of £
by way of deposit made pursuant to section 106 of the Land
and Income Tax Act, 1916, as security for the due payment
of income-tax on the profits derived from the business
of .

Such deposit to be returnable at the discretion of the
Commissioner of Taxes. ……………

Commissioner of Taxes, Wellington.

Dated this day of , 19 .

Countersigned by , Collector of Customs [or Receiver
of Land and Income Tax].

———

FORM No. 25.

The Land and Income Tax Act, 1916, and Amendments.

WARRANT TO NON-RESIDENT AGENT UNDER SECTION 105.

To .

I, , the Commissioner of Taxes within the Dominion
of New Zealand [or Collector of Customs at , as the
case may be], in pursuance of the power conferred on me by
section 105 of the Land and Income Tax Act, 1916, do hereby
authorize you to act in New Zealand as a non-resident agent
for or on behalf of [Names, addresses, and lines of business of
principals].

This warrant shall continue in force for two months from
the date hereof, but may be revoked at any time before the
expiry of such period. You are respectfully requested to
forward this warrant to the Commissioner of Taxes at Wel-
ington prior to your departure from New Zealand.

Given under my hand at , this day of
, 19 .
……………

Commissioner of Taxes [or Collector of Customs].

———

FORM No. 26.

The Land and Income Tax Act, 1916, and Amendments.

WARRANT TO NON-RESIDENT TRADER TO CARRY ON BUSI-
NESS IN NEW ZEALAND UNDER SECTION 105.

To .

I, , the Commissioner of Taxes within the Dominion
of New Zealand [or Collector of Customs at , as the
case may be], in pursuance of the power conferred on me by
section 105 of the Land and Income Tax Act, 1916, do hereby
authorize you to carry on business in New Zealand as a non-
resident trader [Insert here address and line of business].

This warrant shall continue in force for two months from
the date hereof, but may be revoked at any time before the
expiry of such period. You are respectfully requested to for-
ward this warrant to the Commissioner of Taxes at Wellington
prior to your departure from New Zealand.

Given under my hand at , this day of
, 19 .
……………

[Commissioner of Taxes or Collector of Customs].

F. D. THOMSON,
Clerk of the Executive Council.

———

Apportioning Amounts payable to various Acclimatization
Societies for Opossums taken in their Districts.

———

JELLICOE, Governor-General.

ORDER IN COUNCIL.

At the Government Buildings at Wellington, this 20th day
of March, 1922.

Present :

THE RIGHT HONOURABLE W. F. MASSEY, P.C., PRESIDING
IN COUNCIL.

IN pursuance and exercise of the powers and authorities
conferred upon him by the Animals Protection Amend-
ment Act, 1920, and of all other powers and authorities
enabling him in this behalf, His Excellency the Governor-
General of the Dominion of New Zealand, acting by and with
the advice and consent of the Executive Council of the said
Dominion, doth hereby provide and declare that the sum of
eight hundred and eighty-three pounds seven shillings and
ninepence, being two-thirds of the net revenue derived from
the payment of fees, fines, and royalties with respect to the
taking of opossums, shall be paid to the acclimatization
societies referred to in the Schedule hereto in the amounts
set opposite the name of each respectively.

———

SCHEDULE.

Amount.
£ s. d.
Acclimatization Society.
Auckland .. .. .. .. 0 0 8
Grey .. .. .. .. 2 7 9
Nelson .. .. .. .. 0 7 9
North Canterbury .. .. .. 5 8 9
Otago .. .. .. .. 495 5 5
Rotorua .. .. .. .. 2 5 7
South Canterbury .. .. .. 0 11 11
Southland .. .. .. .. 101 1 6
Taranaki .. .. .. .. 0 5 7
Wanganui .. .. .. .. 4 15 5
Wellington .. .. .. .. 253 8 8
Westland .. .. .. .. 17 8 9

Total .. .. .. .. £883 7 9

———

F. D. THOMSON,
Clerk of the Executive Council.