Schedule C.

Form of Receipt of Acknowledgment to be Endorsed on Mortgages or Further Charges.

We, the undersigned, being Trustees of the within named Mutual Benefit Building and Investment Society of Canterbury (Permanent), do hereby acknowledge to have received of and from the within named Mortgagor, his heirs, executors, administrators, or assigns, all moneys intended to be secured by the within written deed.

As witness our hands,

Dated at Christchurch this____day of____18