This form is used when the government wants to give you some land. It's part of a process called the Public Works Act. You might get this land because the government took some of your land for a project, or because their project affected your land in some way.

The form asks for information about you, like your name and address. It also describes the land you'll get, including how big it is and any rules about how you can use it. The form will say when you can start using the land and if there are any special conditions or restrictions.

At the bottom of the form, an important government person has to sign it. This could be someone from the land department, the railways, or another government office. Their signature means that everything on the form is correct and that you're allowed to have this land.