Dlingtting.
no 259
12th November, 1873.
to
Guemor Garanz comb, 00 In Auction S Cermeday! The Night Chonorable
The Carl of Shimberlay
Mr. Ball Persim.
Transmits revised
Return regarding -
SUPERANNUATION ACT OF 1859.
13973
PARTICULARS required to be furnished in reference to Persons recommended for Super-
annuation, Compensation or Compassionate Allowances, or Gratuities on retirement. 405
1. Name of Applicant Dessy John
2. Office or Situation
3. Recommended for
Ball
Judge of the Court of Summary Jurisdiction
• Superannuation under Olingtone Pension Munnite of 1862.
4. Age $3 lart
June
5. Service in Years and Month's
6. Salary Wages (
7. Emoluments*
Ten years and light Muistic in Hongtong
Actual
Mil
) £1,000
Total amount of Salary age and Emoluments, on which
Superannuation, &c., is claimed,...............................
[LEAVE THIS SPACE BLANK.]
£1,500.
1
Endisine
a. Here state the description of allowance for which the applicant is recommended, viz, Superannuation, Compensation, Compassionate Allowance, or Gratuity. In the case of persons claiming under the 4th Clause of the Act of 1859, this should be stated, and reference should be made to the Warrant or Order under which the claim is made.
b. If the Service has been interrupted by one or more breaks, the word "broken" should be added before or after the number of years and months, the causes, dates, and circumstances of the bronk or breaks should be stated on the second page of the form under heading 9.
e. If the person retiring has been in receipt of the same salary, or in the class from which he retires, for three years immediately before the date of his retirement, the actual annual rate of salary or wages at that date should be inserted, preceded by the word "actual." In other cases the average annual amount of salary or wages for the three years next preceding the date of retirement should be inserted, preceded by the word "average," but if the whole period of service is less than three years, then the average for the whole period of service should be inserted.
d. A separate statement should be inserted of the average annual value for the last three years of each emolument (exclusive of salary or wages) which is claimed to be included in the calculation of the pension or gratuity.