1296
THE NEW ZEALAND GAZETTE.
[No. 35

7. Clause 24 of the principal Order is hereby amended by omitting the words “offices of the Resident Commissioners in Savai’i and at Aleipata”, and substituting therefor the words “office of the Resident Commissioner in Savai’i”.

8. Clause 30 of the principal Order is hereby amended by omitting the words “twenty-eight”, and substituting therefor the words “thirty-five”.

9. Clause 31 of the principal Order is hereby amended—
   (a) By omitting the words “twenty-one”, and substituting the word “thirty”;
   (b) By omitting the word “five”, and substituting the word “ten”;
   (c) By omitting the word “ten”, and substituting the word “fifteen”.

10. Clause 33 of the principal Order is hereby amended by omitting from the proviso thereto the words “or a Commissioner of the High Court”, and substituting therefor “or any elector”.

11. The First Schedule to the principal Order is hereby amended by omitting Form No. 1 thereof, and substituting the following form therefor :—

Form No. 1.
CLAIM FOR ENROLMENT.

To the Registrar of Electors for Western Samoa.
I, [Name in full], hereby claim to have my name inserted on the electoral roll for Western Samoa; and I declare that the answers to the following questions are true and correct in every particular :—

1. What is your sex, male or female ?……………………………………………………………
2. Have you attained the age of twenty-one years ?………………………………………
3. Do you reside in Western Samoa ?……………………………………………………………
4. Have you continuously resided in Western Samoa for one year immediately preceding the date of this claim for enrolment ?……………………………………………
5. Are you already enrolled ?………………………………………………………………………
6. What is your present full residential address ?…………………………………………
   …………………………………………………………………………………………………………………
7. What is your occupation ?………………………………………………………………………
8. (a) Are you the legitimate son of parents of European descent ?……………………
   (b) Are you the legitimate son of a father who is a European ?…………………………
   (c) Are you registered as a “European” under the Samoa Registration of Europeans Regulations, 1920 ?…………………………………………………………………………………
   (d) Are you the legitimate son of a father registered as a “European” under the Samoa Registration of Europeans Regulations, 1920 ?………………………………………
9. (a) Are you possessed of freehold or leasehold property, or both, within Western Samoa ?………………………………………………………………………………………………………
   (b) What is the capital value thereof ?………………………………………………………
   (c) Have you paid all taxes due in respect of such property ?…………………………
10. Have you paid a store-tax or business-license fee by virtue of an ordinance in force in Samoa ?………………………………………………………………………………………
11. (a) Are you possessed of an annual income derived from salary of not less than £200 earned in Western Samoa ?……………………………………………………………
    (b) Have you paid all taxes due on such income ?…………………………………………
12. If you are at present in receipt of an annual income derived from salary the annual value of which it is not practicable to ascertain, have you during the two years immediately preceding the closing of the roll paid all taxes due in respect of an income of not less than £200 earned in Western Samoa ?………………………………………

[Signature of Claimant.]
Signed and declared by the claimant this …………………… day of ……………………, 19 …….
Witness :…………………………………………………………………………………………………
Residential address of witness :…………………………………………………………………
………………………………………………………………………………………………………………
…………………, Registrar.
[Or other appointed officer, or Postmaster, or Elector.]

C. A. JEFFERY,
Acting Clerk of the Executive Council.