Nov. 4.] THE NEW ZEALAND GAZETTE. 2937

booth, and shall not communicate to any person, except
for some purpose authorized by law, before or after the poll
is closed, any information likely to defeat the secrecy of
the poll.

(2.) No person, except as hereinbefore provided, shall
interfere with or attempt to interfere with a voter when
engaged in recording his vote, or otherwise attempt to obtain
in the polling-booth information as to the manner in which
any voter in such booth is about to vote or has voted, or
communicate at any time to any person any information
obtained in the polling-booth as to the manner in which
any voter at such booth is about to vote or has voted.

(3.) Every person in attendance at the counting of the
votes shall maintain and aid in maintaining the secrecy of the
voting, and shall not communicate any information obtained
at such counting as to the manner in which any vote is given
in any particular voting-paper.

SCHEDULE.

Form No. 1.

VOTING-PAPER AT POLL OF MAORI ELECTORS UNDER
SECTION 3 OF THE HOROUTA DISTRICT LICENSING POLL
ACT, 1922.

PUKAPUKA POOTI (Voting-paper).

Horouta Maori District.

Ko te Ingoa Iriiri, Maori
hoki, o te Tangata Pooti
(Christian name and sur-
name of elector)

Tane, Wahine ranei ..
(Sex)

Iwi ...
(Tribe)

Hapu ...
(Sub-tribe)

Kainga ...
(Abode)

Consecutive No.:

Consecutive No.:

PATAI (Question).

E pooti ana ranei koe kia hoatu te waipiro [Yes]
ki te Maori o tenei takiwa? [No]

(Do you vote that liquor be supplied to the
Natives of this district?)

Kai-titiro:

(Witness, Maori associate.)

Deputy Returning Officer.

Form No. 2.

DECLARATION BY RETURNING OFFICER, DEPUTY RETURNING
OFFICER, OR SUBSTITUTE AT POLL OF MAORI ELECTORS
UNDER SECTION 3 OF THE HOROUTA DISTRICT LICENSING
POLL ACT, 1922.

I, [Name in full], Returning Officer [or one of the Deputy
Returning Officers, or substitute] for the Horouta Maori
District, at a poll of electors to be taken under section 3,
of the Horouta District Licensing Poll Act, 1922, on the
day of , 19 , do solemnly declare that I
will faithfully perform the duties of that office to the best
of my ability; that I will maintain and aid in maintaining
the secrecy of the voting at that poll; and that I will not
communicate to any person, except for some purpose autho-

rized by law, before or after the poll is closed, any information
likely to defeat the secrecy of the poll.

[Signature of declarant.]

Signed and declared at this day of
, 19 , before me,
C. D.,
Justice of the Peace [or Postmaster].

Form No. 3.

NOMINATION OF PERSONS TO APPOINT SCRUTINEERS FOR POLL
OF MAORI ELECTORS UNDER SECTION 3 OF THE HOROUTA
DISTRICT LICENSING POLL ACT, 1922.

For the purposes of a poll to be taken in the Horouta Maori
District, on the day of , 19 , under section 3
of the Horouta District Licensing Poll Act, 1922, we, the
undersigned electors of the district, hereby nominate [Full
names, addresses, and occupations of the two persons nominated]
as fit persons to appoint one scrutineer to act at each polling-
place in the interest of all electors who are in favour [or, as
the case may be, not in favour] of the proposal that liquor be
supplied to Natives in the said district. And in support of
this our nomination we hereby severally solemnly declare
that we are and we verily believe each of the persons nomi-
nated as aforesaid to be honestly in favour [or, as the case
may be, not in favour] of the proposal that liquor be supplied
as aforesaid.

[Signature, address, and occupation.]

1
2.
3.
4.
5.
6.
7.
8.
9.
10.

Severally declared by each of the declarants whose signa-
tures are subscribed hereto, this day of
, 19 , before me,
C. D.,
Justice of the Peace [or Postmaster].

Form No. 4.

RETURNING OFFICER'S SELECTION OF PERSONS TO APPOINT
SCRUTINEERS AT A POLL OF THE MAORI ELECTORS, UNDER
SECTION 3 OF THE HOROUTA DISTRICT LICENSING POLL
ACT, 1922.

HAVING considered the nominations duly lodged in this
behalf, and having heard all objections thereto, I hereby
select [Full names, addresses, and occupations of the two
persons selected] as fit persons to appoint one scrutineer to
act at each polling-place in the Horouta Maori District, at the
poll of Maori electors to be taken on the day of
, 19 , in the interest of all such electors who are
in favour [or, as the case may be, not in favour] of the pro-
posals that liquor be supplied to Natives in that district.

Dated at this day of , 19 .

Returning Officer.

Form No. 5.

APPOINTMENT OF SCRUTINEERS TO ACT AT THE POLL OF
MAORI ELECTORS UNDER SECTION 3 OF THE HOROUTA
DISTRICT LICENSING POLL ACT, 1922.

To the Returning Officer.

For the purposes of a poll of the Maori electors of the
Horouta Maori District, to be taken on the day of
, 19 , under section 3 of the Horouta District
Licensing Poll Act, 1922, we, the undersigned, being duly
authorized in this behalf, hereby appoint the persons men-
tioned in the Schedule hereto to act as scrutineers at the
polling-places named in that Schedule in the interest of the
Maori electors of the said district who are in favour [or, as
the case may be, not in favour] of the proposal that liquor
be supplied to Natives in that district.

SCHEDULE.

Scrutineer. Polling-place.
[Full name, address, and occupa- [Name of polling-
tion of scrutineer.] place.]

Dated at this day of , 19 .
[Signatures of two persons authorized to appoint.]