CO129-316 - Governor Sir Blake - 1903 [1-4] — Page 16

THE SCHEDULE.

Form A.

Titles Register.

I

of

FORM D.

Mortgage.

hereby certify that on the appeared before me A.B. (or X.Y., the duly

1Æy

and C.D. (or

constituted Agent of A.B.) of

Y.Z. the duly constituted Agent of C.D.) of

And thereupon the said A.B. (or the said X.Y. on behalf of A.B.) declared that he (or that the said A.B.)

is the registered holder of the customary land described in the Titles Register Book folio

And that he the

said A.B. bas mortgaged to C.D. his interest in the said land (or in part of the said land) that is to say (here describe the land mortgaged) as security for the re-payment to the said C.D. (on the

} of the prin- cipal sum of ol

嘛

day of

(with interest thereon at the rate

per cent. per wensem,) which said principal sum has been actually advanced to him the said A.B. by the said C.D.

And the said C.D. (or the said Y.Z. on behalf of C.D.) declares that he agrees to accept the mortgage above- mentioned as security for the said sum of $ interest.)

*(and

(Signed.)

Registrar

[* Omit when the mortgage is customary.]

70

1901

I

Lay of

FORM B.

Declaration under Section 6.

hereby certify that on the

appeared before me A.B. (or X.Y., the

duly constituted Agent of A.B.) of

And thereupon the said A.B. (or the said X.Y. on behalf of A.B.) declared that he (or that the said A.B.) was then the registered holder of the customary lands described in the Schedule hereto. And that he (or the said A.B.) has now sold his interest in the said lands to C.D. in consideration of the sum of $ which has actually been paid to bia

the said A.B.

And the said C.D. (or Y.Z. on behalf of C.D.) declared that he the said C.D. had purchased the interest of the said A.B. in the said land in manner aforesaid.

(Sigued.)

Registrar.

FORM E.

Statutory Declaration under Section 16.

In the matter of 1. I

died on the

do solemnly and sincerely declara that to the best of my knowledge and belief

of day of

. 19 and that at the time of

death the deceased was the registered holder of the customary lands described in the Titles Register Book folio

at

2. I further solemnly and sincerely declare that the fol- lowing persons are the heirs of the deceased and entitled to share in the inheritance, that is to say

the

And I make this solemn declaration conscientiously believing the same to be true and by virtue of the provi- sions of

Declared before me at

day of

Justice of the Peace, Notary Public or other person authorised to administer declarations.

19

Nod

FORM C.

Register of Transfers.

Date.

Hour.

From whom.

To whom.

Book Folio.

Demarcation

District.

Lot No.

Particulars of Transaction.

Sector

of

of Land Revenue.

FORM F.

Declaration by the Registrar of Titles.

Transmission by Inheritance under Section 16,

I hereby certify that on the

appeared before me

day of

who thereupon declared that they are entitled (by law) to share in the inheritance of

deceused

in respect to the following customary lands described in

the Titles Register Book

folio

(a.) Aud the said heirs agreed to be registered jointly as customary land-holders in respect to the sail land.

or

(b) And the said heirs agreed before me that

shall be recognized as the customary land-holder in respect to the said land.

07

(c.) And the said heirs agreed to have the said land partitioned among them in the following shares that is to say --

07

(d) And whereas the said heirs disputed how the said fant should be partitioned I have duly enquired into the nutter and havo assigned the shares ae fol- lows:-

(Signed.)

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