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Form 77 (Eeg. 19). Under Section 109 of " The Mining Act, 1898." Claim setting forth Full Particulars of the Compensation that will be required in the Event of Watercourse being constituted and set apart for discharge of tailings. To the Minister of Mines, at Wellington. Whereas by notice published in the Gazette on the day of , 1 , it is stated that application has been made to His Excellency the Governor to constitute and set aside by Proclamation the watercourse described in Table A hereunder to be a watercourse into which may be discharged tailings, debris, and waste water produced by or resulting from mining operations : And whereas by the operation of such Proclamation, if made, the lands described in Table B hereunder, in which I have an interest, as described in Table C hereunder, will be damaged or injuriously affected by reason that [Here state items of claim, with a reference number to each, and give in each case full particulars of the nature and extent of each such item] : Now, therefore, this is to give, notice that in the event of such Proclamation being made I shall claim £ as compensation for all loss and damage arising from the operation thereof, which sum is made up as follows : — [Here state reference number and short £ s. d. heading of each item of claim previously detailed, and the amount claimed in respect of each such item separately.] Total claim ... Given under my at , this day of , 1 Claimant : [Christian name and surname in full]. Address : [Address in full] . TABLE A. [Here describe the watercourse, as in the Gazette notice.] TABLE B. [Here describe the area and situation of the lands affected, giving name of survey district and number and block of section, or other means of identification.] TABLE C. [Here state in full the nature of the interest, as owner in fee-simple, mortgagee, lessee, or occupier ; and if the lands are leased or encumbered, or subject to any easement, give particulars thereof.]

SECOND SCHEDULE.

SUBSTITUTED FORMS. Form 78 (Beg. 28). Application for Prospecting Warrant or License in Eespect of other than Native Land. To the Warden of the Mining District, at Pursuant to "The Mining Act, 1898," the undersigned [Full name, occupation, and residence],

hereby applies for a prospecting warrant [or ordinary prospecting license or tunnel prospecting license] in respect of the following land (being other than Native land) : — [Here specify and identify the land with reasonable particularity by reference to its area, situation, and ownership ; in the case of a tunnel prospecting license specify also starting and terminal points, estimated length, and proposed course of the tunnel.] Address for service : Date and number of miner's right: Dated this day of , 1 Signature of applicant : a!b. [Or, as the case may be, A.B. (by his Solicitor or Eegistered Agent, CD.).] Precise time of filing of the foregoing application : [e.g., 24th July, 1899, at 2.30 p.m.]. Time and place appointed for the hearing of the application and all objections thereto : [e.g., Thursday, 10th October, 1899, at 10 a.m., at Warden's Court at ]. Objections must be filed in Court and notified to applicant at least two- days before the day so appointed. , Mining Eegistrar.

Form 79 (Eeg. 28). Application for License for a Claim. Pursuant to "The Mining Act, 1898," the undersigned [Full name, occupation, and residence], hereby applies for a license for a special dredging claim [extended quartz claim, or otherwise as the case may be] , as specified in the Schedule hereto, in respect of the land therein referred to, which has been duly marked out for the purpose. Address for service : Date and number of miner's right: Dated this day of , 1

SCHEDULE.

[Signature of applicant.] Precise time, &c. [as in Form No. 78].

Form 80 (Eeg. 28). Application for Water-race. To the Warden of the Mining District, at Pursuant to " The Mining Act, 1898," the undersigned [Full name., occupation, and residence], hereby applies for a license for a water-race as specified in the Schedule hereto, the course whereof has been duly marked out for the purpose. Address for service : Date and number of miner's right : Dated this day of , 1 .

Locality where Land is situated, and its Area. Proposed Term of License. ipo en of ;ec Of t m >se< m ise 3d Style under i Proposed which Mode Claim is to of 3. be worked. Working. Remarks.