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Form No. 3.

In the matter of the Native land called or heretofore known as, and of the investigation of the title thereto.

At a sitting of the Court held at, on the day of, 189, before, Esq., Judge, and, Assessor:

It is hereby ordered that the Natives whose names are set out in the first column of the Schedule indorsed hereon, and therein numbered respectively from one to, both inclusive, are, and they are hereby declared to be, the owners of the parcel of land to be called or known as, containing, and delineated in the plan numbered, in the relative shares or proportions set out in the second column of the Schedule; and it is hereby declared that so much and such part of the share of each owner as is set out in the third column of the said Schedule shall be inalienable.

The Sehedule within referred to.

First Column.		Second Column.	Third Column.*
Name.	Sex, and, if Minor, Age.	Relative Interest.	Part declared inalienable.

*When the land is inalienable, the proportional interests should be shown in this column.