H.—l4

8

APPENDIX.

SCHEDULE I. Friendly Societies. (Pursuant to " The Friendly Societies Act, 1877.") Abstract of the Society's experience of health, sick- [ Remarks: ness and mortality for the five years ending 31st day of ' (Signature.) December, 1877. Society established in tbe year , \ (Address by post.) and situated at . (Full particulars respecting any :1. When any particular case of sickness may have cornperson who has been a member during any portion of the ; menced in one year, and continued to the following year, care year are to be entered, whether he have received aliment must bo taken to ascribe the proper quantity of sickness to each during the year or not.) year. Members — 2. In filling up the columns of sickness, Sundays are meant to Name : be included. If it should bo more convenient to exclude them, If married, and wife registered, M to be inserted in this state you have done so. column : 3. If the member's correct date of birth, aud also his age at Occupation or trade : admission into the society, bo known, it will be entered as such ; Country and date of birth : if not, his present age, his age at death or expulsion, as the Date of admission into the society : case may be, must be guessed at or approximated to by the Age at time of admission : person who fills up the Schedule, and also by any other person Date of becoming a free member : who may know t lie member in question, and inserted in the The whole number of days during each year for which the column headed " Remarks." Tbe age on the succeeding birthmember has received aliment in sickness (sick pay) : day should be taken, if not otherwise expressed. Death — 4. The column of deaths, as well as tbe column of members Date of: who have been expelled or who have left the society, must bo Age at: filled up with equal care. Cause of, as stated in medical certificate : 5. If it should happen that the information given respecting Period sick before death (weeks and days) : any particular member stands in need of any explanation, such Date at which the member ceased to belong to the society, is to be given in the column headed " Remarks." whether from arrears of contribution, from expulsion, or 6. It is also to be kept in view that when a member's death is from any other cause except death, stating the cause : recorded, it sliould be stated, in the column headed " Cause of Number of attacks of illness : Death according to the Medical Certificate," for what period he Present age: was ill in the attack of sickness immediately preceding his Deaths of registered wives— death. Date of:

SCHEDULE 11. Foeji of Registeb of Fkiexdey Societies. Register No. j Record Nos. of applications for registry of amendments : Date of registry : Date of registry of special resolutions: Record No. of application for registry : Record Nos. of notifications of special resolutions : Name of society : Date of cancelment of registry : Class of society : Cancelment overruled—Date : Record No. Registered office : Date of cessation : Record Nos. of list of branches : Mode of cessation : Date of registry of amendments of rules : Remarks :

SCHEDULE 111.

List os Societies Kegistebed undeb the Friendly Societies Acts, 1856 and 1867. I.—Independent Oedee op Odd Fellows, Manchestee j Nelson District ... ... ... Nelson. Unity. District Widow and Orphan Fund ... „ Auckland District ... ... ... Auckland. Loyal Howard Lodge ... ... ... „ Loyal Fountain of Friendship Lodge ... ,, „ Nelson Lodge ... ... ... „ ,, G-ood Intent Lodge ... ... „ „ Travellers' Kest Lodge ... ... Eichmond. SndSdge Z '.'.'. '.'.'. AferSndM. Marlborougii district Blenheim. „ Duke of Cambridge Lodge Cambridge. Loyal Marlborougli Lodge „ „ Charles Bruce Lodge Grahamstown. " Lodge Re.nvick. „ Waikato Lodge ... ... ... Shortland. Noeth Canterbury Disteict ... ... Christchurcli. New Plymouth District ... ... New Plymouth. Loyal Benevolent Lodge ... ... ... „ Loyal Egmont Lodge ... ... ... „ » Cily of Christchurcli Lodge... ... „ „ Kaiapoi Lodge ... ... ... Kaiapoi. Wellington District ... ... ...Wellington. u Nil Desperandum Lodge ... ...Oxford. Widow and Orphan Society ... ... „ n Bangiora Lodge ... ... ... Eangiora. Loyal Antipodean Lodge... ... ... „ j; Perseverance Lodge ... ... Woolston. „ Britannia Lodge ... ... ... „ „ Eose of the Valley Lodge ... ... Lower Hutt. Lyttelton District ... ... ... Lyttelton. , , „ . _ . „, , Loyal City of Norwich Lodge ... ... „ Loyal Marton Lodge Marton. Good Intent Lodge Akaroa. Loyal Wanganui Lodge ... ... ... Wanganuj. „ Arowhenua Lodge... ... ... Temuka.