Schedule B.

To the Manager of the Manawatu Permanent Equitable Building and Investment Society.

Sir,

I propose to borrow from your Society the sum of..................being the value of..................Shares in the Society on the following security, viz.:—

Nature or description of security.........................(If town acre, state number, and street frontage and depth of land, or if country land, state number of acres, number of section, and district.)

What does the property consist of................................

Nature of buildings, if any...................................

Situation.................................

Tenure.................................

If leasehold, the amount of ground rent per annum

When and to whom payable............................

Is the property subject to a prior mortgage............................

Time for which advance is required................................

Interest when payable.........................

If insured...............................

Amount...........................

In what office........................

Valuation survey fee......................

And I offer, on demand, to execute a mortgage of the above property to the Society in accordance with the Rules of the Society, and if from any cause I fail to complete the transaction, I undertake, on demand, to pay you the reasonable costs of investigating the title and preparing the necessary mortgage deed, in accordance with the said Rules.