SEPT. 6.] THE NEW ZEALAND GAZETTE. 2331

SCHEDULE.

STRICTLY CONFIDENTIAL.

Form No. 1.

New Zealand Customs.

COMPLAINT RESPECTING GOODS IMPORTED FROM COUNTRIES HAVING DEPRECIATED CURRENCIES.

Place : , 19 .
Date : , 19 .

To the Hon. the Minister of Customs, Wellington, New Zealand.

I, [Full name of person signing complaint], [Position held, e.g., partner, director, manager, chief clerk, or principal officer] of [Full name of complainant(s)], being (a) manufacturer(s) of [or agent(s) of (Full name and address of manufacturers), manufacturer(s) of] [Name of class or kind of goods respecting which complaint is made], the manufacture of which is an industry established in New Zealand [or name of other part of British dominions], do hereby complain that goods of the class or kind aforesaid are imported or may be imported into New Zealand without payment of the special duty imposed under section 13 of the Customs Amendment Act, 1921, as amended by section 18 of the Finance Act, 1921–22, and do require you to determine whether or not the importation of such goods will prejudicially or injuriously affect the aforesaid industry established at [Name of town(s) and street(s) where industry established], in New Zealand [or name of other part of British dominions].

To assist you in determining the matter, I submit the following particulars respecting the industry of manufacturing goods of the class or kind concerning which this complaint is made :—

(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 : . | (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 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 [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, 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.