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Received from this day of ,191 , the sum of , being in full satisfaction and discharge of the within-written obligation. The New Zealand State-guaranteed Advances Office Superintendent, , Mortgagee. Signed by , the New Zealand State-guaranteed Advances Office Superintendent, and scaled with the seal of his office in the presence of — , a member of the New Zealand State-guaranteed Advances Board. Correct for the purposes of the Land Transfer Act. , Solicitor for the Mortgagee.

Under the New Zealand State-guaranteed Advances Act, 1909. Mortgage Docket. (To be. registered as a deed of conveyance of land by way of mortgage under the provisions of the Deeds Registration Act, 1908.) Mortgagor : [Name in full, address, and occupation]. Lund : [Area and particulars]. Mortgagee : The New Zealand State-guaranteed Advances Office Superintendent. Principal sum : Date of advance: Due date and amount of first prescribed half-yearly instalment : And for the purpose of securing to the Superintendent the payment of the aforesaid principal sum of , with interest and other moneys, in accordance with the provisions of this deed and of the New Zealand State-guaranteed Advances Act, 1909, the above-named hereby convey[s] and assure[s] to the Superintendent by way of mortgage the land above described, with all the appurtenances thereto belonging. In witness whereof the said ha hereunto subscribed name this day of , one thousand nine hundred and , Mortgagor. Signed by the above-named in the presence of— Name : Occupation: Address:

Under the New Zealand State-guaranteed Advances Act, 1909. Memorandum of Readjustment of Loan. Pursuant to the provisions of the above-mentioned Act, the original loan of £ secured by the within mortgage, registered as number , is hereby readjusted as follows:— Amount of fresli loan : £ Date on which fresh loan is deemed to be granted : Due date and amount of first prescribed half-yearly instalment: In witness whereof this memorandum of readjustment has been executed by the Superintendent this day of , 191 . The New Zealand State-guaranteed Advances Office Superintendent: Signed by the said Superintendent in the presence of—

The New Zealand State-guaranteed Advances Office Superintendent hereby acknowledges to have received all moneys intended to be secured by the within-written deed [registered No. ]. Dated this day of , 191 . The New Zealand State-guaranteed Advances Office Superintendent : Signed by , the New Zealand State-guaranteed Advances Office Superintendent, and sealed with the seal of his office in the presence of— , a Member of the New Zealand State-guaranteed Advances Board.

' [Indorsement.] Dated ,191 . To the New Zealand State-guaranteed Advances Office Superintendent. MORTGAUK. Approximate t'ott of I'aper. —Preparation, not given ; printing (1,400 copies), £1 17s. «,|

By Authority : John Mackay, Government Printer, Wellington.—l9lo. Price 3d.]