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for the same or any part thereof from any other person or persons or charge the same or any part thereof in account or otherwise to any other person or persons either generally or particularly so as to be again paid or compensated for the same or any part thereof directly or indirectly in any manner whatsoever. And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Justices of the Peace Act, 1908.

Declared at this day of , 192, before me— ,[Justice of the Peace or Solicitor or Notary Public].

NOTE.—This form is to be filled up so as to suit the circumstances affecting each particular case, and in terms of the regulations.

[Form F.

STAMP DUTIES ACT, 1923, PART XI.

STATEMENT by Racing Club to be forwarded to the Commissioner of Stamp Duties within Seven Days after the Conclusion of a Race Meeting pursuant to Section 196 of the said Act:

Name of racing club:

Date(s) of meeting:

Name of secretary:

Address for service:

Declaration.

I, [Insert name, place of abode, and occupation], do solemnly and sincerely declare,—

1. That I am the [State position held in club] of the [State name of the racing club], situated at

2. That the said [state name of the racing club] held a race meeting at , on the day(s) of 192 .

3. That the statements hereunder written marked “A,” “B,” and “C,” contain full and true statements of the amounts in respect of which totalizator duty, dividend duty, and stakes duty, respectively, are payable in connection with the said race meeting.

4. That the aforesaid statements marked “A,” “B,” and “C,” also contain full and true statements of the amounts of totalizator duty, dividend duty, and stakes duty respectively payable in respect of the said race meeting.

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the Justices of the Peace Act, 1908.

Declared at , this day of , one thousand nine hundred and , before me— Justice of the Peace [or Solicitor or Notary Public].

Statement “A” hereinbefore referred to.

Totalizator Duty.

Rate of Amount
Duty of Duty
payable.

Totalizator receipts (gross takings)—
First day .. ..
Second day .. ..
Third day .. ..
Fourth day .. ..
Total
Receipts from other sources :— Admissions to racecourse orany part thereof— Turnstiles .. .. Lawn entrance .. .. Outside gates .. .. Other gates (if any) .. Rebate from Railway Department Luncheon rights .. .. Booth rights .. .. Race-cards rights .. .. Amusements rights .. Other licenses (except licenses to jockeys and trainers)

Total .. ..

Total receipts from totalizator and other sources
Total amount of duty payable, at 2½ per cent.

NOTE.—The words “licenses granted to any person,” as used in section 192 (1) of the Act include all licenses, permits,

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or authorities (under whatever name) issued by a racing club to do any act whatever in relation to a race meeting. Duty is payable accordingly on all the sources of revenue, such as sales of programmes or racing-cards, the licenses or right to retail liquors, &c., and the receipts from the sale of rights for amusements, or any other sources of revenue for which permits are issued.

Statement “B” hereinbefore referred to.

DIVIDEND DUTY.

Dividend duty is computed at the rate of ls. for every pound of dividend.

Statement “C” hereinbefore referred to.

STAKES DUTY.

Stakes duty is computed at the rate of 10 per centum of the aggregate amount of the stakes won. Section 194 (1).

Summary of Duties payable.

Totalizator duty as per Statement A ..
Dividend duty as per Statement B..
Stakes duty as per Statement C

Total duties payable

Form G.

STAMP DUTIES ACT, 1923, SECTION 134 (4).

QUARTERLY STATEMENT by a Bank in respect of Cheques exempted from Stamp Duty in Consideration of the Payment of a Sum by way of Commutation of such Duty.

Name of bank :

Quarter ended the day of , 192 .

Dutiable value of exempted cheque forms on hand at the commencement of the said quarter £

Dutiable value of exempted cheque forms received from printers during the said quarter.. £

Dutiable value of exempted cheque forms supplied to customers or issued during the said quarter.. £

Dutiable value of exempted cheque forms remaining on hand at the close of the said quarter .. £

I, [Name and designation of certifying officer and name of bank], do hereby certify that the foregoing statement is true and correct in every particular, and that there was owing by the said bank at the close of business on the day of , 192 , by way of commutation of stamp duty on cheques exempted from such duty in pursuance of regulations made under the provisions of the Stamp Duties Act, 1923, the sum of £

Dated at this day of , 192 .