New Zealand Gazette – 1922 – No. 67

Page 2384

✨ Discharged Soldiers Settlement Forms



2384
THE NEW ZEALAND GAZETTE.
[No. 67

Form No. 11.
APPLICATION FOR AN ADVANCE UNDER SECTION 2 OF THE
DISCHARGED SOLDIERS’ SETTLEMENT AMENDMENT ACT,
1917, FOR THE ERECTION OF A DWELLING ON OTHER
THAN RURAL LAND.

To the Land Board for the Land District.

I, [Name in full], of [Address and occupation], hereby apply,
under the provisions of section 2 of the Discharged Soldiers
Settlement Amendment Act, 1917, and the regulations there-
under, for an advance for the erection of a dwellinghouse in
accordance with the attached plans and specifications on the
land hereinafter mentioned, namely :—

Section. Block. Locality. (Give Particulars of Streets, &c.) Area. Reference to Title in Land Transfer or Deeds Registry Office.

Plans and specifications, which may be inspected at any
District Lands and Survey Office, are available for use of
applicants free of charge. Applicants desiring their own
designs must submit plans and specifications prepared by
an architect.

For the purposes of this application I make the following
replies to the questions hereinafter set forth :—

Question. Answer.
1. What is your full name and Regimental No.?
2. Of what Naval or Expeditionary Force were you a member?
3. What was—
(a.) Your length of service in such Force?
(b.) The date of your discharge?
(c.) The reason of your discharge?
4. What physical disabilities (if any) do you suffer from by reason of wounds or disease resulting from your naval or military service? State particulars as to loss of limb or faculty, or as to condition of health.
5. (1.) Have you applied for a pension under the War Pensions Act, 1915?
(2.) If so, has your application been (a) granted, or (b) refused, or (c) not finally dealt with?
(3.) If granted, to what rate of pension are you entitled?
(4.) If refused, what were the grounds of refusal?
(5.) In the case of an applicant who is married,—
(a.) To what rate of pension under the War Pensions Act, 1915, is your wife entitled?
(b.) To what rates of pension are you entitled under the said Act in respect of your children (if any)?
6. What is the amount of capital at your disposal for use on the land?—
(a.) Amount of cash
(b.) Value of other assets
7. Are you single, married, or a widower? If married or a widower, state number of children (if any) dependent on you.
8. What land (if any) do you at present own or have an interest in? Give particulars.
9. If married, what land (if any) does your wife own or have an interest in? Give particulars.
10. Is land subject to any encumbrance? Give particulars.
11. Where may titles be obtained?
12. Are there any buildings on the land? Give particulars.
13. Are buildings insured? State office and amount.
14. Do you intend to enter into personal residence upon the land?
15. Have you at any time held land or received an advance under the Discharged Soldiers Settlement Act? If so, state particulars.

Dated at this day of , 19 .
[Signature of applicant.]

Statutory Declaration to accompany Application for an Advance
under Section 2 of the Discharged Soldiers Settlement Amend-
ment Act, 1917, for the Erection of a Dwelling on other than
Rural Land.

I, [Name in full], of [Address and occupation], do solemnly
and sincerely declare—

  1. That I am a discharged soldier within the meaning of
    the Discharged Soldiers Settlement Act, 1915.
  2. That my answers to the questions set out in the said
    application are true and correct in every particular.
    And I make this solemn declaration conscientiously believing
    the same to be true, and by virtue of the Justices of the Peace
    Act, 1908.

[Signature.]

Declared at this day of , 19 ,
before me—

Justice of the Peace for New Zealand
[or Solicitor, or Notary Public].

Form No. 12.
APPLICATION FOR DWELLING UNDER SECTION 4 OF THE DIS-
CHARGED SOLDIERS SETTLEMENT AMENDMENT ACT, 1917.

To the Land Board for the Land District.

I, , hereby apply under section 4 of the Discharged
Soldiers Settlement Amendment Act, 1917, and the regula-
tions thereunder, to purchase the undermentioned land
together with the residence (a) erected thereon, or (b) to be
erected thereon, in accordance with (1) standard design
No. , (2) plans and specifications attached.

NOTE.—Standard plans and specifications, which may be
inspected at any District Lands and Survey Office, are avail-
able for use by applicants. Applicants who require other
designs must attach plans and specifications prepared at their
own cost by a qualified architect.

Section. Block. Survey District. Area.

For the purposes of this application I make the following
replies to the questions hereinafter set forth :—

Question. Answer.
1. What is your full name and Regimental No.?
2. Of what Naval or Expeditionary Force were you a member? Give Regimental No.
3. What was—
(a.) Your length of service in such Force?
(b.) The date of your discharge?
(c.) The reason of your discharge?
4. What physical disabilities (if any) do you suffer from by reason of wounds or disease resulting from your naval or military service? State particulars as to loss of limb or faculty, or as to condition of health.
5. (1.) Have you applied for a pension under the War Pensions Act, 1915?
(2.) If so, has your application been (a) granted, or (b) refused, or (c) not finally dealt with?
(3.) If granted, to what rate of pension are you entitled?
(4.) If refused, what were the grounds of refusal?
(5.) In the case of an applicant who is married,—
(a.) To what rate of pension under the War Pensions Act, 1915, is your wife entitled?
(b.) To what rates of pension are you entitled under the said Act in respect of your children (if any)?
6. What is the amount of capital at your disposal?—
(a.) Amount of cash
(b.) Value of assets in property
7. Are you single, married, or a widower? If married or a widower, state number of children (if any) dependent on you.
8. What land (if any) do you at present own or have an interest in? Give particulars.


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VUW Te Waharoa — PDF NZ Gazette 1922, No 67


NZLII — PDF NZ Gazette 1922, No 67




✨ LLM interpretation of page content

🗺️ Memorandum of Mortgage Form (continued from previous page)

🗺️ Lands, Settlement & Survey
Mortgage, Land, Discharged Soldiers Settlement Act

🛡️ Application for Advance under Discharged Soldiers Settlement Amendment Act

🛡️ Defence & Military
Advance, Dwelling, Discharged Soldiers, Land Board

🛡️ Statutory Declaration for Advance Application

🛡️ Defence & Military
Declaration, Discharged Soldiers, Land Board

🛡️ Application for Dwelling under Discharged Soldiers Settlement Amendment Act

🛡️ Defence & Military
Dwelling, Purchase, Discharged Soldiers, Land Board