Western Australian Consolidated Regulations

WAR SERVICE LAND SETTLEMENT SCHEME REGULATIONS 1954 - THIRD SCHEDULE

Correspondence No. ...............................

S. 824.

WESTERN AUSTRALIA

The War Service Land Settlement Scheme Act 1954

Lease No. .......................................

APPLICATION FOR A PERPETUAL LEASE

Division ............................................................. Land District ..................................

Plan .............................................. Location or Lot No. .............................................

I HEREBY apply for a Perpetual Lease of the Crown Land described below under the provisions of the War Service Land Settlement Scheme Act 1954 , and the Regulations in force thereunder for the time being. I do not own any land or interest in any land except that which is described on the back hereof, and I am otherwise duly qualified to hold land under the abovementioned Act. ............................................ Signature of Applicant. Date .......................................		Office References Noted on Public Plan ............................ Surveyed, see Diagram or O.P. ............ Passed on Plan. ..................................... Examined .............................................. Approval Notice Issued ........................ Sketch sent to Land Agent ...................
Name at full length, address, and calling of Applicant	Description of Holding applied for	Particulars
	Location or Lot Nos. .....         ....................................         ....................................being the whole of the land comprised in farm W.S.L.S. No. .....         ....................................	Value of Structural Improvements Half‑yearly instalment on structural improvements Rental half‑yearly commencing from the termination of Assistance period ................... project (subject to increase for improvements to be apportioned)	$ ........... $ ........ $ ........

Received this application on ................................... of .................................. 20 .......

..........................................................

Chairman, Land Settlement Board.

Application approved, as shown above, to a depth of .............................. metres below
the natural surface, and subject to any necessary survey, this ............................. day
of ....................................... 20 .......

Lease to extend from .............................................................................. 20 ........

..........................................................

An officer authorised in this behalf
by the Governor, by order of the
Minister for Lands.

....................................... Accountant.

Date ....................................... 20 .....

If applying for more than one holding please state order of
preference on back hereof.

PARTICULARS OF LAND OWNED OR ANY INTEREST IN LAND OWNED BY THE APPLICANT

Land District ................................... Road Board District .......................................
Location or Lot Nos. .......................................Total Area .......................................
Nature of interest therein, e.g. , freehold, leasehold, partnership, sharefarming agreement, etc.

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I wish to apply for the holdings in order of preference as shown hereunder.

Preference No.	Farm No.	Preference No.	Farm No.
1	........................................	16	........................................
2	........................................	17	........................................
3	........................................	18	........................................
4	........................................	19	........................................
5	........................................	20	........................................
6	........................................	21	........................................
7	........................................	22	........................................
8	........................................	23	........................................
9	........................................	24	........................................
10	........................................	25	........................................
11	........................................	26	........................................
12	........................................	27	........................................
13	........................................	28	........................................
14	........................................	29	........................................
15	........................................	30	........................................

..........................................................

Signature of Applicant.

[Third Schedule amended in Gazette 24 Aug 2004 p. 3662.]