1484
THE NEW ZEALAND GAZETTE.
[No. 40

(2) The fee payable by a proprietor on an application for approval of any label or advertisement relating to any stock-remedy made at any time after registration of the stock-remedy and during the same period of registration shall be 10s.

(3) The fee payable on an application for the registration of a new proprietor shall be 2s. 6d. in respect of the first stock-remedy and 1s. in respect of each additional stock-remedy to which the application relates.

(4) The fee payable under section 13 (4) of the said Act by the proprietor or the vendor for a copy of the Analyst’s certificate where no discrepancy materially to the prejudice of a purchaser is found in any sample of a stock-remedy taken and analysed under the said Act shall be £1 1s.

(5) The fee payable under section 14 (2) of the said Act on an application for the taking and analysing of any sample of any stock-remedy in the possession of the applicant shall be £2 2s.

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SCHEDULE.
[Form No. 1, Reg. 2 (4).

The Stock-remedies Act, 1934, and the Stock-remedies Registration Regulations, 1935.

REGISTER OF STOCK-REMEDIES.

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[Form No. 2, Reg. 3 (1).

The Stock-remedies Act, 1934, and the Stock-remedies Registration Regulations, 1935.

APPLICATION FOR REGISTRATION OF A STOCK-REMEDY.

The Registrar,
Stock-remedies Registration Board,
Care of Department of Agriculture,
Private Bag, Wellington, C. 1.

PURSUANT to section 6 of the above Act application is hereby made for the registration of the undermentioned stock-remedy, the particulars of which are set out below :—

1. Name of stock-remedy : .

2. Description or representation of every trade-mark to be used in respect of the stock-remedy, and registered number if registered : .

3. Composition of stock-remedy :—
   Names of ingredients : .
   Form of ingredients : .
   Proportions present : .*

4. Method of preparation of stock-remedy (if a vaccine, serum, or other biological product) : .

5. Preventive or remedial properties claimed : .

6. Date beyond which stock-remedy will be ineffective (where applicable) : .

7. Enclosed with this application are the following documents :—
   (i) Specimen copy (in duplicate) of the label to be used in respect of the stock-remedy :
   (ii) Specimen copy (in duplicate) of the advertisement (if any) to be published in respect of the stock-remedy.

8. The prescribed fee for registration is also enclosed, viz. : .

Dated at , this day of , 19 .

Signature of Applicant : .

• Minimum proportion to be stated (to be expressed as a percentage by weight in the case of a solid stock-remedy or as a number of grams per 100 c.c. in the case of a liquid stock-remedy) except where the ingredient is a poison within the meaning of the Poisons Act, 1934, when the maximum as well as the minimum proportion must be stated. A semi-fluid stock-remedy is deemed to be a solid only if recommended for use by weight. It is unnecessary to state the proportions of ingredients which are shown under the heading “adjuvants,” “emulsifiers,” or “inert ingredients” and for which no specific efficacy is claimed.

N.B.—The prescribed fee may be lodged to the credit of the Public Account at any branch of the Bank of New Zealand and the first portion of the lodgment-slip should accompany the application for registration.

If payment of the prescribed fee is made by cheque exchange must be added where necessary.

[Form No. 3, Reg. 3 (3).

The Stock-remedies Act, 1934, and the Stock-remedies Registration Regulations, 1935.

STATUTORY DECLARATION.

I, (A.B.), of [Address] being the proprietor (or the managing director or manager or secretary or other responsible official [Describing his office], of the [Name of firm or company], the proprietors) of the stock-remedy (stock-remedies) set out in the application(s) for registration dated the day of , 19 , attached or appended hereto, do solemnly and sincerely declare as follows :—

1. That I have been duly authorized to make the said application(s) and this declaration in support thereof on behalf of the said firm (or company). (Where declaration is made by the proprietor this paragraph should be deleted.)

2. That the signature to the said application(s) is in the proper handwriting of me this declarant.

3. That to the best of my knowledge, information, and belief the particulars relating to the stock-remedy (stock-remedies) set out in the said application(s) are true and correct in all respects.

And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Justices of the Peace Act, 1927.

A.B.

Affix Declared at this day of 3s. , 19 , before me—
stamp.

C.D.,
Justice of the Peace (or Solicitor or Notary Public).

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[Form No. 4, Reg. 4 (1).

The Stock-remedies Act, 1934, and the Stock-remedies Registration Regulations, 1935.

CERTIFICATE OF REGISTRATION OF A STOCK-REMEDY.

THIS to certify that, pursuant to the application of [Name of proprietor] of [Address of proprietor], dated the day of , 19 , the undermentioned stock-remedy (stock-remedies) is (are) hereby registered under the Stock-remedies Act, 1934, for the registration period ending the 31st day of May, 19 .

Name of stock-remedy :

Dated at Wellington, this day of , 19 .

Registrar, Stock-remedies Registration Board.

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[Form No. 5, Reg. 5 (1).

The Stock-remedies Act, 1934, and the Stock-remedies Registration Regulations, 1935.

APPLICATION FOR APPROVAL OF LABEL OR ADVERTISEMENT RELATING TO A REGISTERED STOCK-REMEDY.

The Registrar,
Stock-remedies Registration Board,
Care of Department of Agriculture,
Private Bag, Wellington, C. 1.

PURSUANT to section 8 (3) of the above Act, application is hereby made for approval of the label ( (and) advertisement) of which two copies are attached or appended hereto relating to the undermentioned registered stock-remedy (stock-remedies) :—

Dated at , this day of , 19 .

Signature of applicant.

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[Form No. 6, Reg. 7 (2).

The Stock-remedies Act, 1934, and the Stock-remedies Registration Regulations, 1935.

FORM OF LABEL TO BE AFFIXED TO SAMPLE OF STOCK-REMEDY.

SAMPLE of [Name of stock-remedy] duly registered under the Stock-remedies Act, 1934, on the application of [Name and address of proprietor] taken on the day of , 19 , for analysis under the said Act in the presence of [Name of proprietor or vendor or other witness present when sample is taken].

Signature of Inspector : .

Signature of proprietor, vendor, or other witness present : .