(4)
Instructions referred to on page 1.
If this Paper of Particulars and the Certificates connected with it, he not sent in original, the copies must be duly altested.
Head of Paper-In the case of an Officer serving on the West Coast of Africa, a statement is to be added whether be is
a native of that Coast. (Colonial Regulations, § 430.)
Head 3-State the description of Allowance for which the Application is recommended, viz., Superannuation, Compensation Compassionate Allowance, or Gratuity, and its amount, In the case of Persons claiming an addition to their Pousion in respect of Professional or other special qualifications, this should be stated, and a reference should be given to the authority under which the claim is made.
Head 5.-If the service has been interrupted by one or more breaks, the word "broken" should be added before or after the number of years and months, and the causes, dates and circunstances of the break or breaks should be stated ander heading 9,
Head 6-If the person retiring has been in receipt of the same Salary, or in the class from which he retires, for the a
months immediately before the date of his retirement, the actual annual rate of Salary or Wages at that date should inserted, preceded by the word "actual." In other cases the average amual amount of Salary or Wages for the a months next preceding the date of retiremout should be inserted, preceded by the word "average," but if the whee period of service is less timu three years, then the average for the whole period of service should be inserted, Head 7-A separate statement should be inserted of the average Amunal Value, for the 36 months immediately preceding retirement, of cach Emolument (exclusive of salary or wages) which is claimed to be included in the calculation d the Pension or Gratnity.
Whenever the value of a House or Honse Allowance, so ascertained, exceeds one-sixth of the salary and othe emoluments which count for Pension purposes, it is to be reduced to one-sixth of that amount, so that it shall ne excccd one-seventh of the whole.
Fees which an Officer is allowed to retain for his own use will be raken into account for Pension purposes, wifi regular salary, at the annual average of the net receipts of the 36 months next preceding the Officer's retirement These ner reeipts are to be ascertained by deducting from the gross amount of Fees such Office Expenses, &c., et an Officer may have had to defray from his own resources, in performing the services for which he was remunerated Fees. No de luction, however, from the Fees should be made in respect of Office Expenses provided from Publ Funds, for the due discharge of those duties to which a Fixed Salary is annexed, Papers of "Particulars" wha forwarded to the Colonia! Department should be accompanied by formal Declarations from the retiring Officers, showing the amonut received by them for Fees, and the amount defrayed as above for Office Expenses, &c., in each of the the years immediately preceding the retirement. It will be the duty of the Colonial Governments concerned to satish; themselves of the accuracy of such statements before forwarding them to the Colouial Office. In the case of Officers receiving Fixed Salaries and Fees, the Fees will not in ordinary circumstances he allowed to count for Ponsion pur poses to the extear of more than one quarter of the Salaries, and Fees will not in any case be allowed to count for Pension purposes during any period in which the whole time of the Officor receiving them was not given to the Publi Service.
Hoad 8.—In cases of infirmity, if the Applicant is below the ordinary age for retirement, s Medical Certificate is to le furnished showing that he is disqualified by infirmity of mind or body for discharging the duties of his situation, an that such intrnity is likely to be permanent.
In case of ten years' service or more, this Certificate should be signed by two Officers, of whom at least one shot.
if possible, be a Salaried Officer of the Government.
Head 9. As to "broken" service, see Head 5,
If the Applicant has had any "acting" service, the details must be fully given, with a statement whether or not during the "acting" service, he was connected with the permanent Civil Servies of the Colony.
Head 11.-If, in special eircumstances, a professional Civil Officer has been allowed to have "private practice" withou
forfeiting his claim to Pension, the facts are to be fully stated.
Head 14.--If the Applicant is liable to any deduction from his service under Clause 102 of the Colonial Regulations, the
facts should be fully stated.
Head 19.-The length of service and other particulars of the computation are to be given. When an average of Saly
&c., is taken, the mode of calculating it (whether by monilis, &c.) is to be explained.
Copy
Enclosure 2
0.0
1453
75
Government Civil
Hospital, 24th November, 1895.
This is to certify that ~ Turnkey James Bodge is _ suffering from old Pleurisy
and chronic Rheumatism and
in our
opinion is not fit to do twelve hours' work per diem at the Gaol.
Matkinson, Aetq. Colonial Surgeon.
(D) James A. Lowson,
Assistant Surgeon.