Nga Ture O Niu Tireni: I Pahitia I Roto I Te Tau Wha Te Kau Ma Rima O Te Kuinitanga O Kuini Wikitoria, Me Te Nohoanga Tuatorutanga O Te Paremete Tuawhitu O Niu Tireni, I noho ki Poneke i timate i te rua te kau ma waru o nga ra o Mei, 1881.
Conditional License
Sec. 36. Conditional License.
Whereas A.B. and C.D., two members of the Licensing Committee, have by their certificate dated the day of, authorized the issue to, being a licensed publican, holding a publican's license for, situate at, of a conditional license for the place and time hereinafter mentioned: And whereas the said hath paid into my office the sum of as the fee on such license: Now I do hereby declare that the said is licensed to sell liquors in any quantity in the premises situate at [Describe place], but not elsewhere, subject to the conditions following, that is to say [Set out the conditions].
This license shall commence upon the day of next, and continue in force until the day of then next ensuing, both inclusive, provided the said sevrral conditions shall be so long fulfilled by the holder hereof, and his license be not forfeited in the meantime.
Given under my hand at, this day of, one thousand eight hundred and.
Treasurer [or Receiver of Revenue].