(2)
(3)
116
Yes
10. Whether each of the Appointments held by the Applicant has been on the Fixed Establishme18. Statement, if the circumstances warrant it, that the Applicant "has discharged his duties with
of the Colony.
'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.
11. Whether the duties of the several offices or situations held since the Applicant entered the Ci
Service has been such as to require that the holder should give his whole time to the Pu Service.
Yes
12. Whether holding any other Public Appointment, or receiving or claiming to receive any Puk
Money by Compensation, Half-pay or otherwise.
No.
13. If any kind of Pension or other Allowance has been commuted under the Imperial Pensia Commutation Acts, 1869 and 1871, and annual amount of Pension or Allowance so commut and the date of Commutation should be inserted.
14. Absence, beyond ordinary Vacation leave :--
cK
ย
The applicant has discharged his duties with diligence and fidelity
to the satisfaction of the Head officer of his Department.
Director of Public Works.
Public
Year.
19. Computation, by the Colonial Secretary, of the Pension, &c.
Period of Absence.
Number of Days.
Cause of Absence.
From
15th Augt.
To 26th Octbṛ
72
I certify that the Pension
which may be paid to the Applicant
18
92
18
:
12
18
25
#
18
31
18
35
18
>>
27
18
21
18
27
11
18
2
"
18
15
*
31st
15. Date of Cessation of Duty, 3/4 December 1894.
16. Date of Cessation of Salary,
314 December 1894.
17. Date from which, inclusively, Pension will commence,../
14 January.
according to the Rules of the Colonial Service, amounts to Five hundred and seven ty dollars.
and I base my Certificate on the following calculation :—
Years
Month s
Days
Length of Service
15
0
24
Less 1/2 or 1/2 pay leave
1
3
14
11
13
Add
5
19
Pension 19/80 or $1800 = $570 .
Vercombabwin.
Treasurer.
Instructions.