1. Category

State

Non State servant

HONOURS RECOMMENDATION FORM

2. List

***

*(Delete as appropriate)

Birthday/New Year 19

3. Full name and title, if any. Forenames first, then sumame only in CAPITALS.

4. Honour recommended

5. Precise national status, je citizenship 6. Present rank or appointment or position

7. Age (years)

8&9 Length of service (years) Total

In present rank or appointment

11. Name and occupation of Spouse

(Non-State servants only)

10. Date of retirement (if within two

years), ruden

12. Previous recommendations 13. Previous Honours and Dates

14. Private address in UK

15. Order of preference (if more than one candidate for same honour)

19. Grounds of recommendation:

17. Recommended by:

Hanauer

16. (National) Salary scale

(State servants only)

18. Date

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