Dec. 17.] THE NEW ZEALAND GAZETTE. 3501

[For District Office use.]

Receiver's fee receipt No.:
Date of receipt:
Receiving officer:
Issue of current heavy-traffic license and
annual license verified:
Date of first inspection:
Date of final check inspection:
No. of certificate:
Date of issue:
Inspecting Officer:
Plan reference Nos.:

Signature of applicant:
Name of business:
Business Address:
Remarks:

Form C.

Transport Licensing Act, 1931.

CONTINUOUS SEASONAL TEMPORARY PASSENGER-SERVICE LICENSE.
License No.

NOTE.-This license is valid only for the route described hereunder.
Name of licensee:
Business address of licensee:

The above-named is hereby authorized to carry on, with (a) vehicle[s] complying with the description set out in Schedule A hereof and to the time-table and on the route respectively described in Schedule B hereof, a passenger-service (particulars of which are set out below) in accordance with the provisions of the above Act, and of the regulations for the time being in force thereunder, and subject to the special conditions herein set forth.

1. Points of commencement and termination of route:
2. Brief description of route and localities to be served (as more particularly described in Schedule B hereof and delineated by sketch plan attached or on the back hereof):
3. Fares prescribed (and charges for goods if carried):
4. The service hereby licensed shall commence on the day of 193 .
5. The licensee must not abandon or curtail the service without the consent of the licensing authority to which must be given twenty-eight days' notice of such intention. (See section 31, subsections (3) and (4) of the Act.)
6. This license expires on the day of , 193 .

NOTE.-Renewal, if required, must be applied for on the appropriate form not less than fourteen and not more than twenty-eight days before the date of expiry shown above.

SPECIAL CONDITIONS.

[Set out any Special Conditions that the Licensing Authority may think fit to impose not inconsistent with the Act or Regulations.]

Dated at this day of , 193 , for the Licensing Authority.

NOTES.-Departure from the terms of this license without authorized amendment thereof or failure to keep its terms may be penalized by a fine of £100, or £10 per day of offence, and may result in revocation of the license. This license is not transferable.

[BACK OF FORM.]
Schedule A.
PARTICULARS OF VEHICLES AUTHORIZED TO BE USED.

Schedule B.
PARTICULARS OF ROUTE, TIME-TABLE, AND VEHICLES PER TRIP.

SKETCH-PLAN OF ROUTE (IF PLAN NOT ATTACHED).

Form D.

NOTE.-A fee of 2s. 6d. must accompany this application.

[Attention is directed to the fact that if any information supplied on this form is false or misleading it renders the applicant liable to a fine of £10.]

Transport Licensing Act, 1931.
APPLICATION FOR TEMPORARY PASSENGER-SERVICE LICENSE.

A separate application must be supplied in duplicate in respect of each separate route (minor deviations not to be counted as a separate route).

To the Licensing Authority,

I, THE UNDERSIGNED, hereby apply for a temporary license under the above Act to operate a passenger-service, particulars of which are given below, and I declare that to the best of my knowledge and belief the statements made herein are true, correct, and complete in every particular.

Usual signature:
Full name of applicant (in block capitals):

[An application by or on behalf of a local authority should be signed by the Clerk or other duly authorized officer, and the name of the authority should be given.]