FORMS |
DEPARTMENT OF AGRICULTURE. |
Government Pasturage Lands Act |
Application for a Licence. | Form 1. |
1. | Name of applicant............................................................................................... |
2. | Residential address............................................................................................. |
3. | Occupation or employment.................................................................................. |
4. | State whether tenant of Government owned land in the same district ...................... |
5. | If tenant, state area and locality of land................................................................ |
6. | Do you own any real property? ................. Where? .............................................. |
7. | Details of above.................................................................................................. |
8. | Do you require a keeping or a grazing licence?...................................................... |
9. | Details of livestock owned by applicant for which permits are required— |
Cattle No. | Horses and Mules | Donkeys No. | Sheep No. | Goats No. |
Bulls ............ | Stallions ........ | Jacks ............ | Rams ........... | Bucks ........... |
Cows ............ | Mares .......... | Jennies.......... | Ewes ........... | Nannies ........ |
Heifers.......... | Geldings ....... | Cubs under 9 mths. age | Wethers ........ | Wethers ........ |
Steers ............ | Mules .......... | | Lambs under Kids under 9 mths. age 9 mths. age |
Calves under 9 mths. age | Foals under 9 mths. Age | | | |
No. ............. | No. ............. | No. .............. | No. ............. | No. .............. |
Age ............ | Age ............. | Age ............. | Age ............ | Age ............. |
Total |
10. Details of livestock kept by applicant but also owned by ...................................... .................................. of .................................... and in which applicant has the following interest— |
...................................................................................................... |
...................................................................................................... |
Cattle No. | Horses and Mules | Donkeys No. | Sheep No. | Goats No. |
Bulls ............ | Stallions ......... | Jacks ........... | Rams ........... | Bucks ........... |
Cows ........... | Mares ........... | Jennies ......... | Ewes ........... | Nannies ........ |
Heifers ......... | Geldings ........ | Cubs under 9 mths. age | Wethers ........ | Wethers ........ |
Steers .......... | Mules .......... | | Lambs under 9 mths. age | Kids under 9 mths. age |
Calves under 9 mths. Age | Foals under 9 mths. Age | | | |
No. ............. | No. ............. | No. ............. | No. ............. | No. ............. |
Age ............ | Age ............ | | Age ............ | Age ............ |
Total |
11. I hereby apply for a licence and I agree to comply with the provisions of the Government Pasturage Lands Act and any regulations made thereunder. |
Signature or Mark ............................ |
Witness to Mark |
...................................................................... |
Justice of the Peace, Minister of Religion, N.C.O. of Police. |