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The SCHEDULE referred to in the foregoing Act.
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FORM (A.)
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FORM OF RETURN TO BE MADE BY THE COMPANY ON APPLICATION TO REGISTRAR TO REGISTER SECURITIES.
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Date of Company’s Mortgage or other Security, and distinguishing Number of Letter.
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Nature of Security, whether Mortgage Grant of Annuity, Rentcharge, or other Security.
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The Amount of Principal Money secured, or, if Rentcharge or Annuity, the Amount and Duration thereof and the Annual or other Periodical Payment to be made on account thereof.
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Tenure, whether Freehold, Copyhold, or Leasehold.
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If the Company’s Charge is upon any of the Securities comprised to Section 5 (a). set out the Extent and Situation of the Property on which the Mortgage or other Security is charged: if Land, state the Acreage, Parish, and County: if Houses, state the Town, Street, and No.. if any, in addition to Parish and County.
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Nature of the Mortgagors’ or Grantors’ Interest therein.
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The Nature and Amount of the Prior Charges thereon (if any); if more than One Charge, set out each Charge separately.
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If the Company’s Charge is upon any of the Securities comprised in Section 5 (b and c), set out the Nature thereof, the Total Amount of the Principal Money originally advanced by the Company, and the Amount unpaid at the Date hereof, and the Authority, standable or other, under which the same is issued.
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We hereby certify that the above Return is correct.
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A.B.
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C.D.
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FORM (B.)
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FORM OF SURVEYOR’S OR VALUER’S DECLARATION.
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[Here insert a Copy of the Return to be made by the Company on Application to register Securities, distinguishing each Security by a separate Letter or Number.]
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I of do solemnly and sincerely declare, that the Information above contained with respect to the Security numbered or lettered is, to the best of my Information and Belief, correct, and that the Value of the Property above described (and, if the Borrower’s Interest is of a limited Nature, the Value of the Borrower’s Estate and Interest or the Property above described,) exceeds the Amount of £, the Advance made by the Company in respect thereof (if there are prior Charges, and of the prior Charges thereon), to the Extent of One Third at least of such Value.
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[A separate Declaration may be made in respect of each Security, and where, the Mortgage or Charge is secured exclusively upon any of the Securities comprised in Sec. 5 (b and c), omit from the Word “declare” to the End, and insert “to the best of my Information and Belief the Security above described, and numbered, is now of the Value of £.”]
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FORM (C.)
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FORM OF QUARTERLY RETURN.
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Mortgage Debenture Act, 1865.
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The First Quarterly Return of the Company, with reference to the 30th Day of December 1865.
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The registered Securities of the Company.
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£
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1. Aggregate Securities under Clause 5—a
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150,000
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2. Aggregate Securities under Clause 5—b
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20,000
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3. Aggregate Securities under Clause 5—c
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10,000
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£ 180,000
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4. Other Investments (to be specifically enumerated)
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.16,500
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5. 40,000 Shares of £50 each held by registered
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Holders
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£2,000,000
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Paid up thereon
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200,000
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Remaining unpaid thereon
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£1,800,000
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LIABILITIES.
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Mortgage Debenture issued and in force.
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No.
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Date.
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Yearly Rate per Cent. of Interest.
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Time for Repayment of Principal.
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Principal Sum secured.
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£
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1
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August 1, 1865
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Four
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August 1, 1869
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10,000
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2
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August 1, 1865
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Four
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August 1, 1869
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5,000
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2
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August 10, 1865
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Three and Three Quarters.
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August 10, 1871
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20,000
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and so on.
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Total - £
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We hereby certify that the above Return is correct.
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A.B.
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C.D.
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FORM (D.)
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FORM OF MORTGAGE DEBENTURE.
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The Company.
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Mortgage Debenture, No.
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By virtue of the Mortgage Debenture Act, 1865, we, the Company, in consideration of £ paid to us by A.B., of do hereby charge all the registered Securities of the Company with the Payment to the said A.B., his Executors, Administrators and Assigns, of the Sum of £, and Interest thereon at the Rate of, which Sum of £ is to be paid and payable to the said A.B., his Executors, Administrators, and Day of with Interest on the same at the Rate of per Cent. per Annum payable half-yearly, at said Place, on every Day of and Day of and we hereby undertake to pay said Sum of £ and Interest at the Rate aforesaid, as above mentioned.
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Given under our common Seal, this Day of
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A.B., Director.
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C.D., Director.
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Countersigned, G.F., Secretary.
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Registered
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FORM (E.)
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FORM OF TRANSFER OF MORTGAGE DEBENTURE.
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I A.B. of in consideration of £ [state true Consideration] hereby transfer to C.D. of his Executors, Administrators, and Assigns, the within Mortgage Debenture.
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(Signed) A.B.
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