Enclosure.

COLONIAL PENSIONS.

36

pension of Seventy three dollars and

thirty three cento per

Pau No, care

locker

Mortuary.

2.

13.33

4026

C. O

3474

PARTICULARS required to be furnished in reference to Persons recommended for Superannuation,

Compensation or Compassionate Allowances, or Gratuities on retirement,

THEG 18 FEB 39,

to

)

C

(In filling up this Puper refer to the Instructions on page 4.)

1. Name of Applicant Pau No

of the Government

Jenclose the usual,

paper of Particulars.

I have the honour to be,

•My Lord,

Your fordship's Mort Obedient,

Humble Servant,

Geld a vous

Enclosu

Mestuary

2. Office or Situation

Caretaker at Public M

3. Recommended for an annual pension

d. Age 47 years

5. Service in Years and Months 5

6. Annual Salary or Wages average:

7. Emoluments

years....

of $73.33

Total amount of Salary or Wages and Emoluments on which

Superannuation, &c., is claimed,.

220

$ fil

8. Cause of Retirement.

ill health

$220

9. Dares of Commencement and Termination of the several Appointments held by Applicant, with their

Emoluments, distinguishing Salary from other Allowances and specifying such Allowances.

Title of Appointment.

Civil Hospital

Coolie Anice

Head Nurse.

Mortuary

Waretaker

Date of Commence-

ment.

Date of Termination.

Salary.

Allowances, &c.

Nature of Allowances, &c.

1843

10th Leptember

spajay

1st January

0 1883

96 96

nit

4

24th July

120

1886

September

240

4

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