Nov. 22.] THE NEW ZEALAND GAZETTE. 2857

FORM No. 5.
NOTICE TO MAKE RETURNS OF INCOME.
Under the Land and Income Tax Act, 1923.
Land and Income Tax Department,
Wellington, , 19 .

NOTICE is hereby given that, in pursuance of the above Act and the regulations made thereunder, every person and company, whether a taxpayer or not, having derived income within the meaning of the said Act during the year ending 31st March, 19 , from any source or by any means which is made the subject of taxation under the said Act, is hereby required to make and furnish to me, in the prescribed form, returns of such income on or before the day of , 19 .

Returns of income are required to be furnished by all companies and persons in business, whether for the whole or part of the income-year. They are also required from all persons in receipt of income from salary, wages, interest, rent, annuity, or other annual payment, where such income exceeds £250 per annum. The returns are required annually from such persons notwithstanding that by reason of the special exemptions allowable by law they may not be liable to pay tax.

In cases where the Commissioner has agreed to accept returns for twelve months ending at a date subsequent to the 31st March, such returns shall be made within two months of such subsequent date.

And, further, notice is hereby given that such returns shall in all cases be delivered at or forwarded to the office of the Commissioner of Taxes, in the Government Buildings at Wellington.

………
Commissioner of Taxes.

FORM No. 6.
LAND-TAX ASSESSMENT NOTICE, 19 -19 .
Land and Income-tax Department,
To . Wellington, , 19 .

TAKE notice that you have been assessed for land-tax in respect of land owned as at 31st March, 19 , as shown below.

If the particulars appearing hereon are incorrect in any respect, you may make an objection in writing, stating shortly the grounds of your objection. The objection must be received at the office of the Commissioner of Taxes, Wellington, not later than , 19 , otherwise the assessment must stand, and tax as assessed will become payable.

This notice should be retained for the purpose of checking the account when received. This is not a demand for tax, the due date for payment of which will be advertised and notified in the post-offices about the end of October.

Under this notice no objection to the value put on the land under the Valuation of Land Act, 1908, can be entertained.

………
Commissioner of Taxes.

Unimproved value of land (particulars hereunder) £
Exemption .. .. .. .. ..
Taxable amount .. .. .. .. ..

Total tax payable .. .. .. ..

FORM No. 7.
INCOME-TAX ASSESSMENT NOTICE, 19 -19 .
Land and Income Tax Department,
To . Wellington, , 19.
Land and Income Tax Act, 1923.

TAKE notice that you have been assessed for income-tax in respect of income derived during the year ended on the 31st day of March, 19 , as shown below.

If the particulars appearing hereon are incorrect in any respect you may make an objection in writing, stating shortly the grounds of your objection. The objection must be received at the Office of the Commissioner of Taxes, Wellington, not later than , otherwise the assessment must stand, and the tax as assessed will become payable,

This notice should be retained for the purpose of checking the account when received. This is not a demand for tax, the due date for payment of which will be advertised and notified in the post-offices about the end of January, 19 .

………
Commissioner of Taxes.

Earned. Unearned.
Gross income .. .. .. £ £
Add .. .. .. £ £
Deductions .. .. .. £ £
Less .. .. .. £ £
—— ——
£ £
Assessable income .. .. .. ——£ ——£
Add .. .. .. .. .. £
——£
Less special exemptions as under—
Under section 74, Land and Income Tax Act, 1923 .. .. .. £ £
Children allowance .. .. .. £ £
Life-insurance premiums, Superannuation and National Provident Fund contributions .. .. .. £ £
Contributions to support of widowed mother .. .. .. £
5 per cent. on capital value, £ , of the taxpayer’s interest in land used £ £
——£ ——£
Taxable income .. .. .. £ £
Total taxable income.. .. .. £

Tax payable on £ .. £
Less 20 per cent. thereof .. £
——
£
,, 10 per cent. in respect of earned income .. £
——
Tax payable .. .. £

FORM No. 8.
NOTICE OF OBJECTION TO ASSESSMENT OF LAND-TAX.
The Land and Income Tax Act, 1923.
To the Commissioner of Taxes, Wellington.

I HEREBY give notice that I object to your assessment of land-tax in respect of land owned by me for the following reasons [Here state shortly and clearly the reasons for objection.]
[Date.] [Name.] [Address.]

FORM No. 9.
NOTICE OF OBJECTION TO ASSESSMENT OF INCOME-TAX.
The Land and Income Tax Act, 1923.
To the Commissioner of Taxes, Wellington.

I HEREBY give notice that I object to your assessment of my income-tax on the following grounds [Here state shortly and clearly the reasons for objection.]
[Date.] [Name.] [Address.]

FORM No. 10.
DECLARATION AND INFORMATION REQUIRED IN SUPPORT OF AN APPLICATION FOR ADDITIONAL EXEMPTION UNDER SECTION 50 OF THE LAND AND INCOME TAX ACT, 1923.

Name of Applicant [Surname, Christian name, and address].

Question. Answer.

1. What is your present age? .. .. ..
2. Are you married or single, widow or widower? ..
3. What is your total annual income from all sources? .. .. ..
4. Are you entirely dependent upon the above income for your support? .. ..
5. Do you receive any monetary assistance from relatives or others; and, if so, how much? Have you included this amount in the total income stated under answer number 3? ..
6. What are the respective ages of those dependent on you for support, if any? [State if wholly or partially dependent; and, if the latter, the extent of dependence] .. .. ..
7. Are you incapacitated by any cause from increasing your income? If so, state cause ..
8. If the premises you occupy are owned by yourself, what is the annual letting value of same? ..