New Zealand Gazette – 1923 – No. 68

Page 2397

✨ Electoral Forms for Western Samoa



SEPT. 13.] THE NEW ZEALAND GAZETTE. 2397

FIRST SCHEDULE.
Form No. (1).
CLAIM FOR ENROLMENT.
To the Registrar of Electors for Western Samoa.
I, [Name in full], hereby claim to have my name inserted on the electoral roll for
Western Samoa; and I declare that the answers to the following questions are true
and correct in every particular:

  1. Have you attained the age of twenty-one years?
  2. Have you continuously resided in Western Samoa for one year?
  3. Are you already enrolled on the electoral roll?
  4. What is your present full residential address?
  5. What is your occupation?
  6. (a.) Are you the legitimate son of parents of European descent?
    (b,) Are you the legitimate son of a father who is a European?
    (c.) Are you registered as a “European” under the Samoa Registration of
    Europeans Regulations, 1920?
  7. (a.) Are you possessed of freehold or leasehold property, or both, within
    Western Samoa?
    (b.) What is the capital value thereof?
    (c.) Are you liable to pay any tax on such property; and, if so, what tax?
    (d.) Are you in possession of an annual income derived from salary of not less
    than £200 earned in Western Samoa?
    (e.) Are you liable to pay any tax on such salary?
    [Signature of claimant.]
    Signed and declared by the claimant this day of , 192 .
    Witness :
    Residential address of witness:
    [Or other appointed officer, or Postmaster, or Elector.]
    Registrar.
    Form No. (2).
    NOTICE OF OBJECTION BY ELECTOR.
    To the Registrar of Electors for Western Samoa.
    I HEREBY give you notice that I object to the name of A. B., of being
    retained on the electoral roll for Western Samoa; and the grounds of my objection
    are the following : [Here state grounds].
    Dated this day of , 19 .
    G. H.
    Form No. (3).
    SUMMONS TO ANSWER OBJECTION.
    To
    You are hereby summoned to attend at the High Court to be held at on the
    day of , at the hour of o'clock in the noon, to prove
    your right to have your name retained on the electoral roll for Western Samoa. If
    you do not attend your name will be removed from the said roll.
    Given under my hand at this day of , 19 .
    Judge of the High Court.
    The grounds of objection to your name remaining on the roll are as follows : [Here
    set out grounds of objection as stated in the notice of objection].
    Form No. (4).
    REGISTRAR'S OBJECTION TO ENROLMENT.
    To
    Take notice that I object to the retention of your name on the electoral roll for
    Western Samoa on the following grounds: [Here state grounds].
    Unless the annexed notice of appeal is signed by you and returned to me within
    days from this date, your name will be removed from the roll.
    Dated this day of , 19 .
    Registrar.
    Part of Form No. (4).
    NOTICE OF APPEAL.
    To the Registrar of Electors for Western Samoa.
    Take notice that I appeal from your objection to the retention of my name on the
    electoral roll for Western Samoa on the following grounds : [Here state grounds].
    Dated this day of , 19 .
    [Signature and address.]


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Online Sources for this page:

VUW Te Waharoa — PDF NZ Gazette 1923, No 68


NZLII — PDF NZ Gazette 1923, No 68




✨ LLM interpretation of page content

🌏 The Samoan Legislative Council (Elective Membership) Order, 1923 (continued from previous page)

🌏 External Affairs & Territories
10 September 1923
Samoa, Legislative Council, Elective Membership, Order in Council, Western Samoa, Disqualification, Electors, Qualifications, Electoral Roll, Offences

🌏 Claim for Enrolment Form

🌏 External Affairs & Territories
Electoral Roll, Enrolment, Western Samoa, Claim Form

🌏 Notice of Objection by Elector Form

🌏 External Affairs & Territories
Electoral Roll, Objection, Western Samoa, Notice Form

🌏 Summons to Answer Objection Form

🌏 External Affairs & Territories
Electoral Roll, Summons, Objection, Western Samoa, High Court

🌏 Registrar's Objection to Enrolment Form

🌏 External Affairs & Territories
Electoral Roll, Objection, Enrolment, Western Samoa, Registrar

🌏 Notice of Appeal Form

🌏 External Affairs & Territories
Electoral Roll, Appeal, Western Samoa, Notice Form