APRIL 13.] THE NEW ZEALAND GAZETTE. 741

To the {Commissioner of Transport, Wellington.
, Licensing Authority,
I, THE undersigned, hereby apply for a {continuous} license
{seasonal}
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.]
On behalf of :
Business address :
Date :
[An application 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 application should be signed by the
owner or one of the owners.]

Question [or particulars required]. Answer.*

1. Is the applicant (if not a local authority 1. . . . . . . . . . .
   or company) over twenty-one years
   of age ?
2. Points of commencement and termina- 2. From. . . . . .
   tion of route ? to . . . . . . . .
3. Description of route, including all 3. . . . . . . . . . .
   minor deviations. (A plan is to be
   attached or sketched on the back
   hereof. If a local service, include
   names of principal streets and roads
   traversed. In other cases give a
   clear description of the route,
   indicating the principal towns passed
   through.)
4. Total number of vehicles proposed to be 4. . . . . . . . . . .
   used in the service, whether regularly
   or in reserve. [The Schedule on back
   hereof must be filled in concerning
   each such vehicle.]
5. Proposed time-table . . . . 5. . . . . . . . . . .
6. Is it proposed that more than one 6. . . . . . . . . . .
   vehicle should be used on the service
   at any scheduled time of departure ?
   If so, give particulars of times,
   vehicles, and passenger-capacity of
   latter, seated and standing.
7. Proposed fares (including any minimum 7. . . . . . . . . . .
   fare and any special terms offered
   for more fares or journeys than one).
8. Are goods (including mails) also pro- 8. . . . . . . . . . .
   posed to be carried ? If so, state
   nature, quantity, frequency, and
   charges during last twelve months.
9. Do you wish to pick up passengers over 9. . . . . . . . . . .
   your whole route ? If not, state
   limitations.
10. Do you propose to carry any passengers 10. . . . . . . . . . .
    whose journey begins and ends
    entirely within a “ Metropolitan
    Transport District ” ? If so, within
    which district ?
11. Proposed date of commencement of 11. . . . . . . . . . .
    service ?

• If there is no room on this form attach a separate signed sheet with
  answer number thereon.

The various types of license are described in the Act
(section 29) as follow :—
“ 29. (a) A continuous license—meaning thereby a license
in respect of a service to be carried on throughout
the year, whether daily or on specified days of
every week, or otherwise at regular intervals,
or a license in respect of special events recurring
at intervals during the year ; ” (e.g., daily, or on
Sundays or race-days, &c.) ; or
“ (b) A seasonal license—meaning thereby a license in
respect of a service to be carried on only during
a period or periods of the year specified in the
license ; ” (e.g., at Christmas, Easter, &c.) ; or
“ (c) A temporary license—meaning thereby a license for
a service to be carried on for a specified period
of not more than seven days or a license for any
specified special occasion or occasions ; ” (e.g.,
exhibitions, special sporting events, &c.).
[For Transport Department’s use only.]
Date receipt stamp :

To be placed before Licensing Authority.
Serial number :
Receiver’s Fee Receipt No. :
Acknowledged and receipt sent :
Position re Certificates of Fitness is
[Initials and date] , 193 .

[BACK OF FORM.]
Schedules of Vehicles.

Current
Registration Plate
No. (on License
Plate).

Make and Model (if
any are Six-wheelers,
state so).

Capacity.

Seating.

Standing.

Class of Heavy-
traffic License, if
any (Class A,
B, C, &c.).

Date Certificate of
Fitness has been or
will be applied for.

Give Particulars of
any other Route
or Routes on which
the Vehicle is used
or proposed to be
used.

Sketch-plan of route (if plan not attached).

Form B.

[NOTE.—A bank receipt must accompany this application
showing that there has been paid in respect of it into the
Public Account to the credit of the Consolidated Fund a fee
of £3.]

APPLICATION FOR CERTIFICATE OF FITNESS IN RESPECT OF A
PASSENGER-SERVICE VEHICLE. [To be supplied in triplicate.]

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

Commissioner of Transport, Wellington.

The District , Department, at .

I HEREBY apply for a Certificate of Fitness in respect of the
motor-vehicle, particulars of which are given below, with a
view to operating it in the service and over the routes specified
hereunder.

1. Name of registered owner :
2. Business address :
3. Garaged regularly at :
4. Current registration-plate No. :
5. Last year’s registration-plate No. :
6. Vehicle fleet No :
7. The {certificate of fitness} last issued expires on [Date].
   {permit}
8. Date when vehicle was first used :
9. Make of chassis :
10. Model, type, and class reference :
11. Engine No. :
12. Chassis No. :
13. Wheel-base :
14. Tires (number on each axle, kind and size) :

Chassis-maker’s Rating, as per Specification or Data Plate. [If
genuine information is not available these items should be
left blank.]

15. Net standard chassis weight (lb.) :
16. Maker’s maximum safe load on chassis (lb.) :
17. Ordinary body-allowance (lb.) :
18. Ordinary seated-passenger capacity ; ; or, if
    commercial type chassis, payload (lb.) :
19. Maker’s recommended gross running-weight of vehicle—
    (a) Laden (lb.) :
    (b) Unladen (lb.) :
20. Any other available data (gear ratio, engine rating, &c.) :
21. Actual tare weight of finished vehicle in running-order
    and fully equipped, excluding driver (lb.) :
22. State whether or not chassis is standard, and, if any
    alterations or additions have been made, describe
    them ; and, if possible, state the resultant added or
    reduced weight of the chassis, as the case may be :
23. Number of passengers for which certificate will be
    sought : seated ; standing :
24. Estimated maximum total weight of—
    (a) Passengers luggage lb. (averaged at 7 lb.
    per passenger, or more in special circumstances)
    (b) Goods : lb.
    25 (a) Vehicle is to be used only as a contract vehicle or
    for carriage only of school children ; or
    (b) Application for a passenger-service license was made
    by me to [granted to me by] the Com-
    missioner of Transport [ Licensing Authority]
    on [Date] :
25. Route :