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New Zealand: Acts affecting Native Lands, 1886, 1888-91 and 1894-95

Schedules

page 16

Schedules.Schedules.

First Schedule. Form of Declaration under Section 5.

In the matter of "The Native Land Laws Amendment Act, 1895," and of an application to the Native Land Court for confirmation of [Specify nature of alienation in respect of which confirmation is required].

I, A. B., of, do solemnly and sincerely declare that I am the person [or one of the persons] beneficially entitled by virtue of the above alienation, and that I do not, either in severalty or jointly with any other person or persons, at the date of making this declaration, own in fee-simple any land in the Colony of New Zealand except the land set forth in the Schedule hereto; and also that such land, if computed on the basis prescribed by section five of the above-mentioned Act, is not equivalent to more than six hundred and forty acres of first-class land, including the land the subject of the above alienation; and, further, that I am not acquiring the said land directly or indirectly for the benefit of any person not named in the instrument effecting such alienation: And I make this declaration conscientiously believing the same to be true; and by virtue of the provisions of "The Justices of the Peace Act, 1882."

Schedule.

[Set forth the section, block, and class of each separate parcel of land.]

Declared, &c.