SCHEDULE A.

West Coast Times, Issue 731, 27 January 1868, Page 4

SCHEDULE A.

Form of application for lease. Place and date. To Sib — I herewith deposit the sum of Twenty Pounds, as required by the Mining Lease Regulations, and I agree, if my application (the particulars of which are hereunder- set forth) be investigated, that such sum shall in all respects be held subject to the terms of such Regulations, and that upon the approval of this application 1 will execute a lease upon the basis therein stated if shall think fit to grant the same. I have, &c, (Signature of Applicant.)

SCHEDULE B. Form of receipt for deposit with Warden. In the matter of the application for a lease under the Mining Lease Regulations. Received from the above-named parties the sum of Twenty Pounds (L2O) pursuant to the Regulations for leases of lands for gold mining. * Signature of Warden. Dated, &c.

SCHEDULE C. Form of notice to be posted by the Surveyor. To all persons whom it may concern. I hereby give notice that residing at did on the day of apply to the Warden, at for a Gold Mining Lease of (acres or yards) of land, which I have this day marked out, and that any person desiring to object to the issue of such lease must, within twenty-one clear days from the date of this notice, forthwith enter hie objection at the office of the said Warden. And I further give notice that the said land is exempted from occupation for any purpose whatever until the application of the aforesaid has been finally dealt with. # Signature of Surveyor. Dated the day of 18 . SCHEDULE D. Form of receipt for deposit with the Warden. In the matter of the application of for a lease under the Mining Lease Regulations, and of objections thereto lodged by A, B, C, D, &c. Received from the sum of Ten Pounds (L 10), pursuant to the regulations for leases of Crown Lands for gold mining. Dated, &c, Signed Warden. J. X.7 Names of applicants L. M.) and addresses. SCHEDULE E. Know all men by these presents, that I, A. B. (or we A. B. and CD.) do hereby make, nominate, constitute, and appoint, and in my (or trar) place and stead put E. F. of (residence and occupation) to be my (or our) true and lawful attorney for me (or us), and in my name (or our names) to accept the lease of auriferous Crown Land for mining purposes for which I (or we) on the day of 18 applied, and the deed of which was on, the day of 18 executed by and for me (or us), and in my name (or our names) and as my (or our) act and deed to sign seal and deliver such deed of lease and for me (or us) and in my name (or our names) to enter into all such covenants and agreements as I (or we) shall be required to enter into in and by the said deed or otherwise in the matter of the said lease, and generally for me (or us) and in my | name (or our names) to do, execute, and perform all such other acts, deeds, and things as may be necessary, or may be required to be done, executed, or performed in and about the acceptance and execution respectively for men (or us) and in my name (or our names) of such lease and deed of lease respectively, and I (or we) do hereby ratify and confirm and covenant that I (or we) will ratify all and confirm all and whatsoever the said E. F. shall lawfully do, or cause to be done, in or about the premises by virtue of this power. In witness whereof.

N.B. — Printed copies of the forms in these schedules will be issued at the Warden's Office free of expense.

Name and Address in full of Applicant. Stylo under which it is intended to conduct the business. Extent of land applied for. Minimum number of men to be employed by the Lessee. Amount of capital proposed to be invested. Proposed mode of working the land. Preciso locality. Term for which lease required. Time of commencing operations. General remarks.