(2)
(3)
351
10. Whether each of the Appointments held by the Applicant has been on the Fixed Establishme: 18. Statement, if the circumstances warrant it, that the Applicant has discharge his duties with
of the Colony.
'diligence and fidelity, to the satisfaction of the Head Officer or Officers of his Department,"
Yes
11. Whether the duties of the several oflices or situations held since the Applicant entered the Civ 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 Appointment, or receiving or claiming to receive any Pull
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 an
the date of Commutation should be inserted,
No.
14. Absence, beyond ordinary Vacation leave, in each of the last 10 years :—
Year.
Period of Absence.
Το
5)
Nil..
18
From
18
}"
*1
18
18
17
>}
18
"J
18
18
18
18
18
23
*
A
*3
יִז
15. Date of Cessation of Duty,...
"
"
""
Number of Days.
Cause of Absence.
19th October, 1897.
L
to be signed by any two of such Heal Officers, if there shall be more than one, or by such
45
“
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 recommendel, 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
am unable to certify !! at the applicant has discharged his duties with fidelity to my satisfaction. He did use
diligence in the discharge of his duties. Capt. Supt. of Police
19. Computation, by the Colonial Treasurer, of the Pension, &c.
I certify that the Pension
according to the Rules of the Colonial Service, amounts to
and I base my Certificate on the following calculation :-
Resident Service Allowance for climate
which may be paid to the Applicant $417€ per annum.
months days.
years
24
5 26.
کرتے
29
22 of $86425 - $41760.
Anyhomson
Acting Treasurer.
16. Date of Cessation of Salary,
19th October, 1897.
17. Date from which, inclusively, Pension will commence,...
19th Cetober, 1897.
Instructions.