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instrument of dissolution [or the alteration of the instrument 3. The grounds upon which such insufficiency is alleged are of dissolution]' appended to. this declaration, the provisions of as follow \_State grounds]. "The Friendly Societies Act, 1877," have been complied with. 4. The Registrar is hereby requested to make or cause to be And I [or we] make this solemn declaration conscientiously made, pursuant to " The Friendly Societies Act, 1877," section believing the same to be true, and by virtue of an Act of the 26, an investigation into the affairs of the society, with a view to General Assembly of New Zealand intituled "The Justices of the dissolution thereof. the Peace Act, 1866." 5. It is desired that notice of the award of dissolution be Made and subscribed at , in the published in the [naming some nev)sj)aper~\, circulating in the Colony of New Zealand, this day city, town, or place of [naming place], in which the registered of , in the year of our Lord one office of the society is situated. thousand eight hundred and , 6. The sum of , being the cost of publishing such before me [one of Her Majesty's notice in the said newspaper, and the further sum of Justices of the Peace in and for the said for the cost of publishing the same in the Gazette, are herewith colony]. transmitted. (Signatures of members.*) Registered office : Date: clay of , 18 . t, t\t o^ 7o An * Any sieuature by mark only must be attested by a witness who does Form No. SS.—Beff. 40. not sig^ as \ me mber New Zealand. " Friendly Societies Act, 1877." Form No. SS.—Seg. 41. ACKNOWLEDGMENT OP REGISTRY OP INSTRU- Kew Zealand. MENT OP DISSOLUTION. Name of society: tern- ji a --a* a i in*- >> Register No. * Friendly Societies Act, 187/." The foregoing instrument of dissolution [or alteration of the instrument of dissolution] of the society is registered NOTICE OF INVESTIGATION. under "The Friendly Societies Act, 1877," this duv of -. T n • t 1 q ■ iName ot society : (Seal ov stamp of Registrar.) No. Notice is hereby given that the Registrar will proceed, by himself [or bv (name of) Actuary, whom the Registrar hereby appoints for the purpose] to investigate the affairs of the abovementioned society, in compliance with an application in that ' behalf) made pursuant to section 26 of the above-mentioned Form No. 3S.—Reg. 42. Act> on » the day oi. > ls Ltwo months at least after the date of the notice], at o'clock, New Zealand. at (Signed) , Registrar. Address: "Friendly Societies Act, 1877." Date: da? of > 1S ■ (To be addressed io the society at its registered office.) ADVERTISEMENT OF DISSOLUTION BY INSTRUMENT. Notice is hereby given that the society, Register No. , held at , is dissolved by instrument, registered at this office the day of , unless within three Form No. 59.—Reg. 44. months from the date of the Gazette in which this advertise- • ■ ment appears, proceedings be commenced by a member or other New Zealand. person interested in or having any claim on the funds of the society to set aside such dissolution, and the same is set aside accordingly. " Friendly Societies Act, 1877." (Signed) , Registrar. Registrar of Friendly Societies' Office, day of , 18 . AWARD OF DISSOLUTION. Name of society : Register No. Pursuant to section 26 of the above-mentioned Act, I hereby award that the shall be dissolved, and its affairs wound Form No. 37. Reg. 43. UP a? rom tlle daJ °^ ; and- -*- c'"'ect that the assets of the said society shall be divided and appropriated in Hew Zealand. lne following manner :— (Signed) , Registrar. Address: " Friendly Societies Act, 1877." Viitc: da? of , 18 . APPLICATION TO REGISTRAR FOR AWARD OF DISSOLUTION. Name of society : Register No. _ „ _ . . , . ,. . ,. r ., , Form No. 4,0—Reg. 45. Application* for an award or dissolution oi tho abovementioned society is mado by the members whose names are New Zealand subscribed at the foot hereof. 1. The society consists of members, one-fifth of the 7 h0l 1 e^ mber ! °f WhT [T 10° °J m°Z I"' 10! ifthe S°cie% " Friendly Societies Act, 1877." lias 1,000 members and not exceeding 10,000, or 500 or more ot whom if the society has more than 10,000 members] have signed this application. AWARD FOR DISTRIBUTION OF FUNDS. 2. The funds of the society are insufficient to meet the existing claims thereon [or the rates of contribution fixed in -Name of society : the rules of tho society are insufficient to cover tho benefits KegiiierJNo. assured]. Puesuant to section 26 of the above-mentioned Act, and to
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