86
THE NEW ZEALAND GAZETTE.
[No. 2

Additional information required from persons in respect of whom the sum of £100 has been paid under section 31 of the Immigration Restriction Act, 1908 :—
No. and date of certificate issued under section 33 of that Act :

Declaration.
I do hereby declare that the above particulars respecting myself [my child under the age of fifteen years] are correct, and that I [my child] am [is] a permanent resident of New Zealand.

Signature : .
Declared before me at , this day of , 19 .
……………
Officer of Customs.

[NOTE.—Where the applicant is departing from New Zealand accompanied by his wife or children a separate application must be made in respect of each individual; provided that where any child of an applicant is under the age of fifteen years the application may be made by his or her parents.]

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[Form 13.
New Zealand Customs.
CERTIFICATE OF REGISTRATION UNDER THE IMMIGRATION RESTRICTION ACTS.
Port of , New Zealand, 19 .
THIS is to certify that [Full name], residing in New Zealand at , being desirous of leaving New Zealand with the intention of returning thereto, has registered with me the following particulars concerning himself/herself.

Particulars.
Full name :
Sex :
Nationality :
Place of birth :
Date of birth :
Height : ft. in.
Build :
Scars or birthmarks (if any) :
Other particulars to aid identification :
Whether or not can speak English :
Date and port of first arrival in New Zealand and vessel by which arrived :
Number, date, and port of issue of certificate (if any) under section 33 of the Immigration Restriction Act, 1908 :
Signature—
In English characters (if possible) :
In any other characters :
If he [she] returns to New Zealand within years from the date hereof, and is identified to the satisfaction of the Collector of Customs as being the person to whom this certificate was issued, he [she] will, on presentation of this certificate, be permitted to enter New Zealand.
……………
Collector of Customs.

[Photograph of person to whom the certificate is granted.]

[Form 14.
New Zealand Customs.
No. . Ship:
DECLARATION BY PERSONS ARRIVING IN NEW ZEALAND.
(To be made by each person fifteen years of age and over. Details to be written in ink.)

1. (a) Surname : . (b) Christian name[s] : .
2. Sex : . Age: .
3. Nationality :
4. Race or people : [State European, Chinese, Japanese, Syrian, Indian, &c.]
   (NOTE.—In the case of a half-caste, the letters “H.C.” are to be added—as, for example, “H.C. European-Chinese,” “H.C. European-Indian.”)
5. Particulars of any firearm, ammunition, or explosive brought with passenger :
   (NOTE.—It is unlawful to land any such goods in New Zealand without authority from a Superintendent or Inspector of Police in the Dominion.)
6. Particulars of children under fifteen years of age arriving with parent or guardian. [If both parents arrive by the same vessel, to be filled in only on the declaration made by the father.]

7. State if a permanent resident of New Zealand returning thereto after a temporary absence : . If so, usual place of residence therein :
   8. If not a permanent resident of New Zealand returning thereto after a temporary absence, state—
   (a) Occupation [Full description] :
   (b) Country where born :
   (c) Country where father born :
   (d) Address while in New Zealand :
   (e) Country in which last permanently resident :
   (f) Whether intending to become permanently resident in New Zealand : . If so, state whether single, married, or widower or widow.
   9 If not intending to become permanently resident in New Zealand, state purpose of visit (e.g., as a tourist, or commercial traveller, or on holiday or business, or for theatrical purposes.)
   (* These particulars are not required from (1) “through” passengers—i.e., those leaving New Zealand by the same vessel on which they arrived and in continuation of the same voyage; (2) permanent residents of New Zealand returning after a temporary absence.)
   I do solemnly declare that the above particulars concerning myself [and my children under fifteen years of age accompanying me] are true and correct in every respect.
   Date :

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

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Amending Description of Herries Memorial Park Domain, Auckland Land District.

CHARLES FERGUSSON, Governor-General.
ORDER IN COUNCIL.
At the Government House at Wellington, this 13th day of January, 1930.
Present :

HIS EXCELLENCY THE GOVERNOR-GENERAL IN COUNCIL.

WHEREAS by an Order in Council dated the sixth day of December, one thousand nine hundred and twenty-six, and gazetted on the sixteenth day of that month (hereinafter referred to as “the said Order in Council”), a Domain Board was appointed to have control of the Herries Memorial Park Domain :
And whereas an error was made in the description of the said domain in the Schedule to the said Order in Council by the inclusion therein of the land described in the Schedule hereto, and it is expedient that this error should be rectified :

Now, therefore, His Excellency the Governor-General of the Dominion of New Zealand, acting by and with the advice and consent of the Executive Council of the said Dominion, and in pursuance and exercise of the powers conferred upon him by the Public Reserves, Domains, and National Parks Act, 1928, and of every other power and authority enabling him in this behalf, doth hereby amend the Schedule to the said Order in Council by excluding therefrom the land described in the Schedule hereto.

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SCHEDULE.
ALL that area in the Auckland Land District containing by admeasurement 1 rood 21 perches, more or less, being Section 2 of Block XXIV, Town of Te Aroha, and being portion of the area of 2 acres 0 roods 14 perches firstly described in the Schedule to the Order in Council dated the sixth day of December, one thousand nine hundred and twenty-six.

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