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The Pamphlet Collection of Sir Robert Stout: Volume 88

The First Schedule

page 39

The First Schedule.

First Part.—Form of Transfer.

This Deed made the ____ day of ____ one thousand eight hundred and ____ between (the Transferor and his address and description) of the first part (the Transferee and his address and description) of the second part and ____ of ____ of the third part Witnesseth that in consideration of the sum of this day paid to the said (Transferor) by the said (Transferer) the receipt whereof is hereby acknowledged the said (Transferor) doth assign and transfer unto the said (Transferee) shares of or in the capital stock of "The Fidelity and Accident Guaranty Company of New Zealand" numbered To hold under and subject to the covenants conditions and provisions contained in the articles and regulations of the said Company and to the laws and regulations for the time being of the said Company affecting the said shares and the said ____ (Transferee) doth for himself his heirs executors and administrators covenant with the said (Transferor) and also as a separate covenant with the said (as Trustee for and on behalf of the said Company) to perform and observe all and singular the covenants conditions provisions laws and ragulations hereinbefore referred to Witness the hands and seals of the said parties the day and year first before written.

Second Part.—Form of Proxy.

I hereby appoint ____ of ____ my proxy to vote for me and in my name at a meeting of the Shareholders of" The Fidelity and Accident Guaranty Company of New Zealand" to be holden on the ____ day of one thousand eight hundred and ____ and at any adjournment of such, meeting.

Dated this ____ day of ____ one thousand eight hundred and

page 40

Third Part.—Form of Power of Attorney.

I (A. B.) of ____ being the holder of ____ shares of or in "The Fidelity and Accident Guaranty Company of New Zealand" numbered ____ do hereby appoint ____ my attorney to sign seal and execute the Memorandum of Association and Articles of the said Company and any other Articles and to consent to abide by fufil observe and perform all other laws, rules, and regulations for the time being of the said Company.

Dated the day of 187 Signed sealed and delivered by the said in the presence of [L.S.]
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Balance Sheet Referred to in Above Articles

BALANCE SHEET OF THE FIDELITY AND ACCIDENT GUARANTY COMPANY OF NEW ZEALAND UP TO 18Dr. Cr.CAPITAL AND LIABILITIES. Showing—PROPERTY AND ASSETS. £ s. d. £ s. d. Showing—£ s. d.£ S. D.1. Capital1 The total amount received from. 3. Property heldImmovable Property, distinguish the Shareholders ...... by the Com-ing—Showing also— (A) The Number of Shares. (B) The Amount per share (C) If any arrears of calls, and the nature of the arrears Any arrears due from any Director or officer of the Company to be separately(A) Freehold Land ...... (B) Ditto Buildings (C) Leasehold ditto ...... Movable Property, distinguishing (D) Stock-in-trade (E) Plant ......... The cost to be stated with deductions for deterioration instated. (D) The particulars of any forfeited Shares.value as charged to the Reserve Fund or Profit and Loss. Show ing—2. Debts andShowing—4. Debts owing6. Debts considered good for whichI bilities ofThe amount of loans on mortgage1to the Com-the Company hold bills or othert Company.2. or debenture bonds ...... The amount of debts owing by the 3. Company, distinguishing— (A) Debts for which acceptance have been given (B) Debts to tradesmen for supplies of stock-in-trade or other articlespany. securities. ... .... 7 Debts considered good for which the Company hold no security 8 Debts considered doubtful and bad; any debts due from a Director or other Officer of the Company to be separately stated Showing(C) Debts for Law expenses5. Cash andThe nature of investment and rate(D) Debts for interest on debentures or other loanslnvestments.of Interest ... ... ... The amount of cash, where lodged(E) Unclaimed dividends (F) Debts not enumerated aboveand if bearing interest6. Resrve Fund.Showing— The amount set aside from profits to meet contingencies7. Profit & Loss.Showing—The disposable balance for pay- ment of dividend, &c. ... 1=—ContingentClaims against the Company not ac-Liabilities.knowledged as Debts ... Moneys for which the Company iscontingently liable

Balance Sheet Referred to in Above Articles.