(2)

(8)

337

yea

10. Whether each of the Appointments held by the Applicant has been on the Fixed Establishment of the Colony.

yea

18. Statement, if the circumstances warrant it, that the Applicant "has discharged his duties with diligence and fidelity, to the satisfaction of the Head Officer or Officers of his Department," to be signed by any two of such Head Officers, if there shall be more than one, or by such Head Officer, if there shall be but one, together with "such a statement as will exhibit the merit, and value, and labour of the services of the Person recommended, embracing as long a period of his public service as can be authentically stated," and observations as to Special Services, Suspension, Reprimand, &c., with full particulars of any injuries received on duty, or other claims or matters for consideration.

11. Whether the duties of the several offices or situations held since the Applicant entered the Civil Service have been such as to require that the holder should give his whole time to the Public Service.

yea

12. Whether holding any other Public Appointment, or receiving or claiming to receive any Public Money by Compensation, Half-Pay or otherwise.

None

13. If any kind of Pension or other Allowance has been commuted under the Imperial Pensions Commutation Acts, 1869 and 1871, the annual amount of Pension or Allowance so commuted and the date of Commutation should be inserted.

none

1. Absence, beyond ordinary Vacation leave, in each of the last 10 years:-

Year From To Number of Days Cause of Absence 1875 31 Aug 24 Dec 1 year 76 months 1878 1879 1880 1882 31 July 19 Aug 19 1883 20 July 26 Aug mouth & 7 day 1883 57 1887 10 Aug 19 Dec 4 months & 10 days

19. Computation, by the Auditor General, of the Pension, &c.

I certify that the superannuation which may be paid to the Applicant according to the Rules of the Colonial Service, amounts to Eight hundred and ninety-seven Pounds Sterling, and I base my Certificate on the following calculation:- see annexed paper.

15. Date of Cessation of Duty, after 28th Feby. 1887.

16. Date of Cessation of Salary, 1st March, 1887.

17. Date from which, inclusively, Pension will commence, from date of retirement.

Frederic Minor Acting Auditor General

Instructions.

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