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The Pamphlet Collection of Sir Robert Stout: Volume 71



I,____, of *____, do solemnly and sincerely declare,—

1. That I am of the age of seventeen years and upwards.

2. That I am applying for a lease of grazing-farm No.

3. That I am applying for such lease solely for my own use [unclear: and] benefit, and not directly or indirectly for the use of any other person [unclear: to] persons whatever.

4. That I am not the holder of any run under Part VI. of "The [unclear: Land] Act, 1892," nor have I any interest in any such run.

5. That I do not own any freehold land or land held by lease or [unclear: licences] of any kind whatever anywhere in the colony, either by myself or [unclear: join the] with any other person, which, exclusive of the land I am now applying [unclear: for] the lease of, will exceed in area 5,000 acres.

6. That I am applying for the said land subject to the provisions "The Cheviot Estate Disposition Act, 1893," and "The Laud Act, 1892

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


Declared at____, this____day of____, 18____, [unclear: befor] me,

A.B., A Justice of the Peace in and for the Colony of New Zealand.

[For a description of each farm see page 45.]

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