CO129-232 - Acting Governor Marsh Acting Governor Cameron - 1887 [4-5]

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of the Colony,

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

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.

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.

A

He has private practice.

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

Nove

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

Nove

14. Absence, beyond ordinary Vacation leave, in each of the last 10 years.

or other claims or matters for consideration.

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

Year Period of Absence Number of Days Cause of Absence 1878 From ... to ... 1879 3rd at ... 1880 +2 18 months & 12 days 1882 J 1883 15 Apr 21 1883-1887 1887 June

I certify that the ... which may be paid to the Applicant according to the Rules of the Colonial Service, amounts to ... and I base my Certificate on the following calculation :----

15. Date of Cessation of Duty.

16. Date of Cessation of Salary.

17. Date from which, inclusively, Pension will commence.

Instructions.

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