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Form No. 30.—Reg. 37. New Zealand. "Friendly Societies Act, 1882." APPLICATION FOR THE CONVERSION OF A REGISTERED SOCIETY INTO A BRANCH. Name of society: Register No. : To the Registrar of Friendly Societies. Application to register the above-mentioned society as a branch of the is made by the three persons whose names are subscribed at the foot hereof. With this application are sent — (a.) Two copies, each marked A, of the resolution passed at a general meeting of the said society, of which notice was duly given, held on the day of , 18 ,by which it was determined that the said society should become a branch under this Act of the above-mentioned (6.) A copy, marked B, of the rules of tho first-mentioned society ['marked to show the amendments made at the above-mentioned meeting]. [*(c.) Two copies, each marked C, of such amendments of rulasj. (Signed) (Secretary of the first- ( named society, j Chairman of the general | meeting. J Secretary of the second- \ named society. Registered office: Date : day of , 18 . * If no amendments of rules were made at the meeting, the words in brackets should be struck out.

Form No. 31.— Reg. 37. New Zealand. "Friendly Societies Act, 1882." DECLARATION TO ACCOMPANY APPLICATION FOR CONVERSION OF A REGISTERED SOCIETY INTO A BRANCH. Name of society: Register No.: We, of , chairman of the meeting at which a resolution was passed for the conversion of the above-men-tioned society into a branch of the , and , of , secretary of the first-mentioned society, do solemnly Mid sincerely declare that the said resolution was duly passed by three-fourths of the members present and entitled to vote at a general meeting of the said society, of which notice was duly given, held on the day of , 18 , and that the amendments to the rules of the said society, accompanying this declaration, were duly made at the said meeting. And we make this solemn declaration conscientiously believing the same to be true, and by virtue of an Act of the General Assembly of New Zealand intituled " The Justices of the Peace Act, 1882." (Signatures.) Made and subscribed at , in the Colony of New Zealand, this day of , in the year of our Lord one thousand eight hundred and , before me, , one of Her Majesty's Justices of the Peace in and for tho said colony. (Signed) Chairman of the general meeting. Secretary of the Society.

Form No. 32.— Beg. 38. New Zealand. "Friendly Societies Act, 1882." CONVERSION OF A REGISTERED SOCIETY INTO A BRANCH. Name of society: Register No.: The registry as a separate society of the is hereby cancelled, and the said society is hereby registered as a branch of the (Signature.) Date : day of ,18 .

Form No. 33.—Reg. 39. New Zealand. "Friondly Socioties Aot, 1882." INSTRUMENT OF DISSOLUTION. Name of society: Register No.: Instrument of dissolution of the , made tho day of , 18 , pursuant to " The Friendly Societies Act, 1882," section 10, and signed by [in the case of a society not a friendly society three-fourths of the members, but in the case of a friendly society five-sixths in value] of the members, including honorary members, if any, and by every person for the time being receiving or entitled to receive any relief, annuity, or other benefit from the funds of the society [except , whose claims have been duly satisfied or have been provided for (State in what manner such provision has been made)]. It is agreed and declared as follows :— 1. The liabilities and assets of the society are the following [Here set them forth in detail]. 2. The number of members is , and the nature of their interests in the society respectively is as follows [Specify nature of benefits, dc] . 3. The society has no creditors other than such members [or if there be any, state the amount due to them and the provision to be made for its payment]. 4. The funds and property of the society shall be appropriated and divided in the following manner [or in such manner as tho Registrar may award]. [Here insert any other provisions the society desires to make as to the dissolution.]

N.B.—All signatures by mark only must be attested by & witness who does not sign as a member. * These consents may bo given separately.

Form No. 34.—Reg. 39. New Zealand. " Friendly Societies Act, 1882." DECLARATION TO ACCOMPANY INSTRUMENT OP DISSOLUTION. Name of society: Register No.: I, ,of , one of the trustees [or we, , and three members and the secretary] of the abovenamed society, do solemnly and sincerely declare that, in making the instrument of dissolution [or the alteration of the instrument of dissolution] appended to this declaration, the provisions of " The Friendly Societies Act, 1882," have been complied with. And I [or we] make this solemn declaration conscientiously believing tho same to be true, and by virtue of an Act of the General Assembly of Now Zealand intituled "The Justices, of the Peace Act, 1882." (Signature or signatures.) Made and subscribed at , in the Colony of New Zealand, this day of , in the year of our Lord one thousand eight hundred and , before me, , one of Her Majesty's Justices of the Peace in and for the said colony.

Signatures of Members. No. of Votes of each Member. Signatures of Persons receiving or entitled to receive any Relief, Annuity, or other Benefit from the Funds of the Society.* (Schedule.) List of Members who have not signed the foregoing J,?'.?, Instrument. *ȣ.