(2)

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

of the Colony.

Yes

>>

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.

You

12. Whether holding any other Public Appointment, or receiving or claiming to receive any Public"

Money by Compensation, Half-Pay or otherwise.

No

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

(3)

110

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.

I hereby certify that Mr. J. M. Butler Overseer in the Public Works Department has discharged his duties with diligence and fidelity since

appointment in May 1889.

my

D. Brown

Ne

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

Year.

Period of Absence.

Number of Days.

Cause of Absence.

19. Computation, by the Colonial Treasurer, of the Pension, &c.

54.

22.7-91

18 PL/

From

To

1883

+3

1884

1

79

1886

11

34

1846

:

38₫y

1888

1889

1890

1891

16th July

15. Date of Cossation of Duty,

16. Date of Cessation of Salary,

15th Sept

}, year

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

42 months

Over Lo resident gervice

15th Sept. 1891

So

16th Sapt 1891

I certify that the

pension

which may be paid to the Applicant

according to the Rules of the Colonial Service, amounts to four hundred and trenty dollars for aumum.

and I base my Certificate on the following calculation

d. Butter joined he service out

The 19th October 1842

as Police boustable, and on the jet Sovember 1879 was tramfered to Public works Department, as overses of works. This sevice up to the 16th September next, when

his leave expires, extend over a period of sixteen epraco and eleven mouchs, but from this must be deducte seven months for leave on half pay - making his risedent service 16 years and 7o mouths. It is entitled to a persion of $420. (K84. 10.0 at 4/2) being 24/60th of

his emoluments of $1200.

ئية

باشد

nymitchell Somer.

Leasurer.

Instructions.

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