2944
THE NEW ZEALAND GAZETTE.
[No. 83

SCHEDULE.
[Form No. (1).
FORM OF APPLICATION FOR REGISTRATION OF MOTOR-VEHICLE
UNDER THE MOTOR-VEHICLES ACT, 1924.
To the Deputy Registrar of Motor-vehicles for the
Provincial District at
.
I HEREBY apply for registration of the motor-vehicle particulars of which are given below:—
Name of owner:
Address of owner:
Situation of garage:
Engine No.:
Chassis No.:
Make of motor-vehicle:
Seating-accommodation: persons.*
Intended for—
Private use; or
Conveyance of passengers; or
Conveyance of goods; or
Conveyance of passengers and goods.
Gross weight of motor-vehicle unladen: tons
cwt. qr. lb.†
Manufacturers’ rating of weight-carrying capacity:
tons cwt. qr. lb.
Dated at , this day of , 19 .
[Signature of Owner.]

• Not required for motor-cycles.
  † Not required for motor-cycles or private motor-cars.

—
[Form No. (2).
CERTIFICATE OF REGISTRATION OF MOTOR-VEHICLE UNDER
THE MOTOR-VEHICLES ACT, 1924.
THIS is to certify that the motor-vehicle, particulars of which are given below, has been registered under the Motor-vehicles Act, 1924.
Description of Motor-vehicle:
Name of owner:
Address of owner:
Situation of garage:
Engine No.:
Chassis No.:
Make of motor-vehicle:
Seating accommodation: persons.*
Intended for—
Private use; or
Conveyance of passengers; or
Conveyance of goods; or
Conveyance of passengers and goods.
Gross weight of motor-vehicle unladen: tons
cwt. qr. lb.†
Manufacturers’ rating of weight-carrying capacity:
tons cwt. qr. lb.
Registration No. and distinguishing marks:
Dated at this day of , 19 .
. . . . . . . . . . . . , Deputy Registrar of Motor Vehicles.
NOTE.—This certificate must be produced to the Deputy Registrar when applying for a transfer of the registration. The Deputy Registrar must be notified if situation of garage altered.

• Not required for motor-cycles.
  † Not required for motor-cycles or private motor-cars.

—
[Form No. (3).
FORM OF APPLICATION FOR LICENSE TO USE MOTOR-VEHICLE
UNDER THE MOTOR-VEHICLES ACT, 1924.
To the Deputy Registrar of Motor-vehicles for the
Provincial District at
.
I HEREBY apply for a license to use the motor-vehicle, particulars of which are given below:—
Name of owner:
Address of owner:
Situation of garage:
Engine No.:
Chassis No.:
Make of motor-vehicle:
Seating-accommodation: persons.*
Intended for—
Private use; or
Conveyance of passengers; or
Conveyance of goods; or
Conveyance of passengers and goods.
Gross weight of motor-vehicle unladen: tons
cwt. qr. lb.†
Manufacturers’ rating of weight-carrying capacity:
tons cwt. qr. lb.
Registration number and distinguishing marks:
Dated at this day of , 19 .
[Signature of owner.]

• Not required for motor-cycles.
  † Not required for motor-cycles or private motor-cars.

—
[Form No. (4).
LICENSE TO USE MOTOR-VEHICLE UNDER THE MOTOR-VEHICLES ACT, 1924.
THE motor-vehicle, particulars of which are set out hereunder, may, in accordance with the terms of the Motor-vehicles Act, 1924, be used on any road or street in New Zealand while this license continues in force.

Description of Motor-vehicle.
Name of owner:
Address of owner:
Situation of garage:
Engine No.:
Chassis No.:
Make of motor-vehicle:
Seating-accommodation: persons.*
Intended for—
Private use; or
Conveyance of passengers; or
Conveyance of goods; or
Conveyance of passengers and goods.
Gross weight of motor-vehicle unladen: tons
cwt. qr. lb.†
Manufacturers’ rating of weight-carrying capacity:
tons cwt. qr. lb.
Subject to the provisions of the Motor-vehicles Act, 1924, this license shall continue in force until the 31st March, 19 .
Dated at this day of , 19 .
. . . . . . . . . . . . , Deputy Registrar of Motor Vehicles.
NOTE.—The Deputy Registrar at whose office the motor-vehicle is registered must be notified if situation of garage altered.

• Not required for motor-cycles.
  † Not required for motor-cycles or private motor-cars.

—
[Form No. (5).
NOTICE UNDER THE MOTOR-VEHICLES ACT, 1924, OF DESTRUCTION OF MOTOR-VEHICLE, OR OF ITS PERMANENT REMOVAL FROM NEW ZEALAND.
To the Deputy Registrar of Motor-vehicles for the
Provincial District at
.
PURSUANT to the provisions of section 15 of the above-mentioned Act, I hereby give notice that the motor vehicle, registered No. , owned by me has—
(a.) Been destroyed:
(b.) Become permanently useless:
(c.) Been permanently removed from New Zealand.
[Strike out the lines not applicable.]
Dated at this day of , 19 .
[Signature of owner.]

—
[Form No. (6).
NOTICE UNDER THE MOTOR-VEHICLES ACT, 1924, AS CHANGE OF GARAGE.
To the Deputy Registrar of Motor-vehicles for the
Provincial District at
.
PURSUANT to the provisions of section 16 of the Motor-vehicles Act, 1924, I hereby give notice that the situation of the garage of the motor-vehicle owned by me and registered as No. has been changed from to .
Dated at this day of , 19 .
[Signature of owner.]

—
[Form No. (7).
NOTICE OF CHANGE OF OWNERSHIP OF MOTOR-VEHICLE REGISTERED UNDER THE MOTOR-VEHICLES ACT, 1924.
To the Deputy Registrar of Motor-vehicles for the
Provincial District at
.
PURSUANT to the provisions of section 17 of the above-mentioned Act I hereby give notice that I have sold [or as the case may be] the motor-vehicle owned by me and registered as No. to , of ; and, as required by the said Act, I forward herewith the certificate of registration and the current license issued in respect of the said motor-vehicle.
Dated at this day of , 19 .
[Signature of owner.]

—
[Form No. (8).
FORM OF ENDORSEMENT OF CERTIFICATE OF REGISTRATION AND OF ANNUAL LICENSE CONSEQUENT ON CHANGE OF OWNERSHIP.
Date of transfer:
Transferee:
Address:
Signature or initials of officer recording transfer:

—
[Form No. (9).
FORM OF APPLICATION BY MANUFACTURER OF OR DEALER IN MOTOR-VEHICLES FOR SPECIAL REGISTRATION-PLATES UNDER THE MOTOR-VEHICLES ACT, 1924.
To the Deputy Registrar of Motor-vehicles for the
Provincial District at
.
I [Name and description], being a manufacturer of [or dealer in] motor-vehicles, hereby apply for [Insert number] registration-plates, for use in accordance with the terms of section 18 of the Motor-vehicles Act, 1924.
Dated at this day of , 19 .
[Signature.]

F. D. THOMSON,
Clerk of the Executive Council.

By Authority: W. A. G. SKINNER, Government Printer, Wellington.
Price, 6d.}