D.—9

4

tbe cost of my journey above mentioned having been refunded by me to the Government, the am ount to my credit is to be paid to me. That in the event of my not fulfilling my contract I will pay to the New Zealand Government the full cost of my journey to New Zealand at the ordinary rates now current, unless such nonfulfilment of the contract be caused by serious illness. That I will conform to the arrangements for the voyage to New Zealand which have been made by the High Commissioner in my interests. [Signature.] Signed in my presence, this day of , 191 . , Justice of the Peace for Approximate Cost of Paper.—Preparation, not given ; printing (650 copies), £2 ss.

Authority : John Mackay, Government Printer, Wellington.—l9l4.

Price 3d.]