Fc.

Memorandum of Mortgage.

[name of mortgagor], of [place of residence], [calling or description], being a shareholder in the Society known as "The ____ Society," in respect of ____ shares numbered [Number or other description of shares. If shares not distinguished by numbers, some other description which will distinguish them, for a mortgagor might have other shares], and being registered as the proprietor of an estate [Here stale nature of the estate or interest], subject however to such encumbrances, liens, and interests as are notified by memoranda underwritten or indorsed hereon, in that piece of land situated [Here state were situate], containing [Here state area], be the same a little more or less [If road intersecting, say "exclusive of road intersecting the same."] [Here state page 41 rights of way, privileges, or easements, if any appertaining; and if the land to be dealt with contains all that is included in any existing grant or certificate of title or lease, refer thereto for description of parcels and diagram; otherwise set forth the boundaries in chains, links, or feet, and refer to plan thereof on margin of or annexed to the mortgage as deposited in the Registry Office], in consideration of the sum of [amount of money advanced] lent to me the said [name of mortgagor] by the Trustees of the Society, out of the funds of the said Society, the receipt of which sum I hereby acknowledge, do hereby covenant with the Trustees of the said Society that I will pay to the Trustees of the said Society, or the person or persons for the time being by or under the rules of the said Society authorized to receive the same, the sum of [the monthly payment in respect of the shares], on the ____ in every month here-after, beginning on the ____ in the mouth of [instant or next ensuing], and all subscriptions, fines, interest, insurance, and other payments to become due according to the rules and regulations of the said Society upou the said shares, and upon the said principal sum of [amount of money advanced] so advanced to me as aforesaid, a copy of which rules and regulations is deposited in the office of the District Land Registrar at ____, in accordance with the provisions of "The Land Transfer Act 1870 Amendment Act, 1871;" and also that I will, during the continuance of the said Society, observe all the said rules and regulations of the said Society until, with the consent of the Trustees of the said Society, I shall pay off such balance as, according to the said rules and regulations of the said Society, may be owing to the said Society in respect of the said principal sum of [amount of money advanced] so advanced to me as aforesaid, with all arrears of sub-criptions, fines, interest, insurance, and other payments hereby covenanted to be paid to the Trustees of the said Society. ____ And the said ____ covenants with the Trustees of the ____ Society that he will insure, and during the continuance of this security keep insured, in some reputable Insurance Office in the ____, to be approved of by the Trustees for the time being of the said Society, against loss or damage by fire, in the names or name of the Trustees for the time being of the said Society, the buildings and erections erected at the date hereof or at any lime thereafter, and for the time being standing and being upou the hereditaments and premises hereby mortgaged, in the sum of ____ pounds at the least, and deliver the policy or policies for such insurance, and the receipt or receipts for every premium in respect of such insurance, to the Trustees for the time being of the said Society at the office of the said Society; and will, in respect of such insurance, abide by and observe the said rules of the said Society in respect of insurances of mortgaged property. And it is hereby declared that all moneys which shall become receivable in respect of such insurance or insurances shall and may, at the option of the Trustees for the time being of the said Society, be either forthwith applied in or towards substantially rebuilding, reinstating, and repairing the buildings and erections for the destruction or damage whereof such moneys may be received, or in or towards payment of all such subscriptions, fines, and other sums of money hereby secured as shall then be due or thereafter accrue due in respect of the said share [Here set forth special covenants, if any].

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And for the better (securing to the Trustees of the Society the payment at the time and in the manner and as aforesaid of such sums, subscriptions, fines, interest, insurance, and other payments as aforesaid, I hereby mortgage to the Trustees of the Society all my estate and interest in the said land and premises above described. And I empower the Trustees of the Society to sell the estate and interest hereby mortgaged to them whenever I shall make default for the space of calendar months and days in payment of any of the said monthly sums, or any of the subscriptions, fines, interest, insurance, or other moneys to become due in respect of the said shares, or any of them, of the said principal sum of [amount of money advanced] so advanced to me as aforesaid according to the rules of the said Society, or in the observance of any of the rules of the said Society, or any of the covenants herein contained. And for the purposes of the fifty-ninth section of "The Land Transfer Act, 1870," the said period of____ calendar months shall he the period upon the expiration of which such notice as is therein mentioned may be given. And for the purposes of the sixtieth section of the said Act, the period of ____ days after the expiration of the said period of ____calendar months shall be the period on the expiration of which such power of sale may be exercised. And, save as heneinbefore mentioned, I hereby confirm unto the Trustees of the ____ Society all the powers and remedies given by a memorandum of mortgage under "The Land Transfer Act, 1870," and any Act amending the same, and all the powers and remedies given by the said rules and regulations.

In witness whereof I have hereunto signed my name, ____ this ____ day of ____

Signed by the above-named ____ as Mortgagor, ____ this ____ day of ____, in the presence of ____