Dec. 17.] THE NEW ZEALAND GAZETTE. 3505

Fleet number of vehicle :
Chassis number :
The certificate of fitness last issued expires on [Date]*:
Is the vehicle to be used in a licensed passenger-service ?
If so, state the Licensing Authority concerned, and the date application for the
license was made :
Is the vehicle proposed to be used on all your licensed routes ?
If not, state limitations :
Dated at , this day of , 193 .
[Signature of applicant.]
[Business address.]

Form I.
Transport Licensing Act, 1931.
REVOCATION OR SUSPENSION OF A PASSENGER-SERVICE LICENSE.
Name of licensee :
Business address of licensee :
THE passenger-service license, number , issued to the above-named by this Licensing
Authority on the day of , 193 , for a service as described below is
hereby revoked [suspended until the day of , 193 ] all the statutory
requirements precedent to such suspension [revocation] having been duly performed.

Description of Service.

1. Points of commencement and termination of route :
2. Description of route and localities to be served :
   Dated at this day of , 193 .

For the Licensing Authority.

Form J.
Transport Licensing Act, 1931.
REVOCATION OR SUSPENSION OF A CERTIFICATE OF FITNESS.
I, { Commissioner of Transport } do hereby revoke [suspend until the
day of , 193 *] the certificate of fitness No. issued on the day
of , 193 , in respect of the vehicle described below.

Particulars of Vehicle.
Name of registered owner :
Business address :
Garaged regularly at :
Current registration-plate number :
Make of chassis :
Model, type, and class reference :
Vehicle fleet number :
Chassis number :
Dated at this day of , 193 .

Commissioner of Transport.
Inspector†.

• Maximum is twenty-eight days from date hereof. † Suspensions only.

Form K.
Transport Licensing Act, 1931.
APPEAL TO TRANSPORT APPEAL BOARD.
[To be made in duplicate.]
To the Chairman of the Transport Appeal Board (forwarded through the Commissioner of Transport, Wellington).
I HEREBY appeal against the decision of the Licensing Authority given at its meeting on the day of , 193 .
The decision was to the following effect, namely: That [e.g., a passenger-service license be granted to William Brown] and the description of the relative passenger-service is as follows :—

1. Name of owner of service (whether an existing or proposed) service :
2. Points of commencement and termination of route :
3. Description of route and localities to be served :
   My interest in the subject-matter of the appeal is: [e.g., I am a competitor over the same route as the licensee] and I pray that the Transport Appeal Board provide relief as follows: [Set out what relief the appellant seeks—e.g., that the passenger-service license applied for by William Brown be not granted].

Usual signature of appellant :
Full name of appellant (in block capitals) :
[An appeal 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.]
On behalf of :
Business address :
Date :
[An appeal by or on behalf of a limited liability company should state the name and address of the registered office of the company and should be signed by the secretary or manager, or other duly authorized official.]
[In any other case the appeal should be signed by the appellant or one of the appellants.]

F. D. THOMSON,
Clerk of the Executive Council.
(TT. 19/2.)
C