3150
THE NEW ZEALAND GAZETTE.
[No. 91

Particulars where the Complaint has reference to an Industry established in New Zealand.

(1.) Average number of persons employed in my/ our factory/factories during 19 : .
(2.) Average total wages per week paid to employees at such factory/factories during 19 : £ .
(3.) Capital invested—
(a.) Value of plant and machinery : £ .
(b.) Value of buildings : £ .
(c.) Value of land used in business : £ .
(4.) Cost of raw materials used in my/our factory/ factories during 19 :—
(a.) Imported : £ .
(b.) Produced in New Zealand : £ .
(5.) Total value at ordinary wholesale selling- prices of goods produced in my/our factory/ factories during 19 : £ .
(6.) Names and addresses (if known) of other New Zealand manufacturers of goods of the class or kind concerning which complaint is made,—
(a.) , .
(b.) .
(c.) , .
(7.) Approximate proportion which the total New Zealand output bears to the total requirements of New Zealand in the above-mentioned goods :
[E.g., the New Zealand manufacturers supply one-half (or one- ) of the requirements of the Dominion.]
(8.) (i.) Name of country/countries having depreciated currencies from which goods of the class or kind concerning which complaint is made are imported into New Zealand—
(a.) .
(b.) .
(c.) .
(ii.) Average weekly wages paid to employees in such countries in the industry of manufacturing such goods (if available),—
(a.) , £ .
(b.) , £ .
(c.) , £ .
(iii.) Authority from which particulars re wages are obtained : .
(9.) Reasons why the importation of goods of the class or kind mentioned injuriously affects the industry in question,—
(a.) The wholesale selling-price at the factory/factories in New Zealand is £ : : per .
(b.) The wholesale selling-price(s) in New Zealand, c.i.f. and duty paid, of similar goods imported from the following countries having depreciated currencies is/are as under,—
(i.) Imported from [Name of country] : £ : : per .
(ii.) Imported from [Name of country] : £ : : per .
(iii.) Imported from [Name of country] : £ : : per .
(c.) Other reasons : .

Particulars where the Complaint has reference to an Industry established in some Part of the British Dominions other than New Zealand.

(1.) Average number of persons employed in my/ our factory/factories during 19 : .
(2.) Average total wages per week paid to employees at such factory/factories during 19 : £ .
(3.) Capital invested,—
(a.) Value of plant and machinery : £ .
(b.) Value of buildings : £ .
(c.) Value of land used in business : £ .
(4.) Total value at ordinary wholesale selling-prices of goods produced in my/our factory/factories during 19 *: £ .
(5.) Names and addresses (if known) of other manufacturers of similar goods in the United Kingdom or in other parts of the British dominions,—
(a.) , .
(b.) , .
(c.) , .
(6.) (i.) Name of country/countries having depreciated currencies from which goods of the class or kind concerning which complaint is made are imported into New Zealand,—
(a.) .
(b.) .
(c.) .
(ii.) Average weekly wages paid to employees in such countries in the industry of manufacturing such goods (if available),—
(a.) , £ .
(b.) , £ .
(c.) , £ .
(iii.) Authority from which particulars re wages are obtained : .
(7.) Reasons why the importations of goods of the class or kind mentioned injuriously affects the industry in question,—
(a.) The wholesale selling-price at the factory/factories in [Name of part of British dominion] is £ : : per .
(b.) The wholesale selling-price in New Zealand, c.i.f. and duty paid, of the goods produced at the above factory/factories is £ : : per .
(c.) The wholesale selling-price(s) in New Zealand, c.i.f. and duty paid, of similar goods imported from the following countries having depreciated currencies is/are—
(i.) Imported from [Name of country] : £ : : per .
(ii.) Imported from [Name of country] : £ : : per .
(iii.) Imported from [Name of country] : £ : : per .
(d.) Other reasons : .

And I do hereby declare that the above-mentioned particulars are correct.

Declared† before me at this day of , 19 .
[Signature.]

. . . . . . . . . . , Officer of Customs
[Postmaster, Customs Agent, Solicitor, or Notary Public].

• Figures for a yearly period should be for the last complete financial year.
  † If the declaration is made outside New Zealand it may be made before any person competent to sign as a witness to signatures on ordinary business documents.

Form 7.
New Zealand Customs.

APPLICATION FOR TEMPORARY REMOVAL OF GOODS FROM A LICENSED WAREHOUSE.
(In Triplicate.)

Port of .
To the Collector, .
Date : , 19 .

I/WE do hereby apply for permission for the removal of the undermentioned goods from warehouse for the purpose of ; and I/we undertake to return the said goods to the said warehouse within [Period of time within which to be returned] from the date hereof in the same condition as when they were delivered from the said warehouse, save and except for such alterations therein as may be made by permission of the Collector of Customs :—

. . . . . . . . . . , Importer(s) [or Agent].