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[Collected Rules and Regulations of the Native Land Court, in English and Māori]

Form No. 50

Form No. 50.

Form of Declaration under Section 39.

"The Native Land Court Act, 1894."

In the Native Land Court, New Zealand.

In the matter of the land known as

I, of, do solemnly and sincerely declare that the application to the Chief Judge of the said Court, annexed hereto, and marked A, has been signed by me with my own proper handwriting [or mark], and that the statements therein contained, so far as they relate to my own acts and deeds, are true and correct in every particular, and, so far as they relate to the acts and deeds of other persons, I do verily believe them to be true and correct.

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of an Act of the page 58General Assembly of New Zealand intituled "The Justices of the Peace Act, 1882."

Declared at, this day of 189, before me, Justice of the Peace [or Solicitor, or Notary Public].