A.—4.

Land Transfer.

SCHEDULES. FIRST SCHEDULE. New [Royal Arms.] Zealand. R f I Warrant No. . Register .Book : ° ° rencC lP.R. Folio ~ Vol. , folio Certificate oe Title under Land Transfer Act. This certificate, dated the day of , nineteen hundred and , under the hand and seal of the District Land Registrar of. the Land Registration District of , being a certificate in lieu of grant under warrant of His Excellency the Governor in exercise of the powers enabling him in that behalf, witncsseth that is seised of an estate in fee-simple (subject to such reservations, restrictions, incumbrances, liens, and interests as are notified by memorial underwritten or indorsed hereon ; subject also to any existing right of the Crown to take and lay off roads under any Act of the General Assembly of New Zealand) in the land hereinafter described, as the same is delineated by the plan hereon, bordered , be the several admeasurements a little more or less, which said land is in the said warrant expressed to have been originally acquired by as from the day of , one thousand hundred ■ , under , that is to say : All that parcel of land containing (1.5.) District Land Registrar.

Schedules. Section 12.

SECOND SCHEDULE. FORM A. Application to bring Land under the Act. I, A. 8., of , do declare that I am [or on behalf of , of , that he is [ seised of an estate of freehold [Here stale -whether of inheritance or of a life estate, and 'whether held in trust] in all that piece of land situated in [Here state the situation], containing [Here stale the area], be the same a little more or less (exclusive of roads intersecting the same, if any), with [Here state rights of way and other privileges or easements appertaining, and set forth a sufficient description to identify the land], which piece of land is of the value of £ and no more, and is the town allotment [or country section, or is part of the town allotment, country section, or reserve] originally granted to , by grant dated the day of , numbered in the plan of the District [County, or Township] of , as delineated on the public maps of the district deposited in the . And Ido further declare that lam not aware of any mortgage, incumbrance, or claim affecting the said land, or that any person has any claim, estate, or interest in the said land, at law or in equity, in possession or in expectancy, other than is set forth and stated as follows —that is to say, [Here state particulars of mortgages, incumbrances, dower, or other interest to which the land may be subject]. And I further declare that there is no person in possession or occupation of the said land adversely to my estate or interest therein, and that the said land is now [Here state name and description of occupier, or that the land is unoccupied], and that [Here stale the names and addresses of owners and occupiers of lands contiguous thereto] ; and that there are no deeds or instruments of title affecting such land in my possession or under my control other than those enumerated in the Schedule hereto or at the foot hereof. And I make this solemn declaration conscientiously believing the same to be true. Dated at this day of ,19 . A. B. Made and subscribed by the above-named A. B. this day of , 19 ,in the presence of me, , District Land Registrar [or Justice of the Peace, or Notary Public].

Section 20.

52