Kia mōhio mai ahau ki ōu mōhiohio tuku i raro nei, kia taea ai e mātou te tuku atu i te hononga utu ki a koe:
(1) Ingoa/Ingoa o te kamupene________________
(2) Tau waea________________
(3) Wāhitau__________________
(4) Tāone_____________
(5) Kāwanatanga_____________
(6) Whenua______________
(7) Waehere poutapeta________________
(8) Īmēra________________