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The Pamphlet Collection of Sir Robert Stout: Volume 29

Schedule E. — Form of Temporary License

Schedule E.

Form of Temporary License.

Otago, New Zealand to wit.

Be it remembered that A.B., holding a General License for (describe the house, place or district for which the same is granted) having applied to me (or us) on the___________day of __________ for authority to exercise the privileges of the said License (describe the place of amusement where) to be holden at ________________ on ___________ the ___________ day of ________ and having paid the sum of one pound sterling as the fee on such license: Now I (or we) do hereby grant authority to and do license the said A. B. to exercise the said License at the said (place of amusement) on the said _____________ day of ________________ and for and during ____________ days thereafter between the hours of ______________ in the morning, and ____________ in the evening: Provided that (here set out any special conditions the Justices have attached in the particular case).

Given under my (or our) hand the day and the year first aforesaid.