74 E

(2)

10. Whether each of the Appointments held by the Applicant has been on the Fixel Establishme

of the Colony.

You

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

Yes

12. Whether holding any other Public Appointinent, or receiving or claiming to receive any Publ

Money by Compensation, Half-pay or otherwise.

otherwh

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

14. Absence, beyond ordinary Vacation leave:--

Mo

(3)

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 "nerit, 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 certify that James storge has discharged

Auties

with dilig

oyster

and fixility to the satisfaction of the stead of

Department.

Thomson

Aching Superintendent

Vitoria Gast!

Year.

Period of Absence.

Number of Days.

Cause of Absence.

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

18

From

To

18

;:

יו

18

37

"

18

18

18

18

Nil

18

18

27

18

which may be paid to the Applicant

Cants Thinky mely

I certify that the pension according to the Rules of the Colonial Service, amounts to hundred and Severely live and and I base my Certificate on the following calculation

Service

Add

15. Date of Cessation of Duty, „Ž0th November 1895-

16. Date of Cessation of Salary, „30th November

ber 1895

17. Date from which, inclusively, Pension will commence,.../ December 1890

21/60 of $1349.48

4X

16

5

21

years

6472.30

Millwarthrckbart

Colonial Secretary

Instructions.

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