(2)

(3)

150

10. Whether each of the Appointments held by the Applicant has been on the Fixed Establishing. Statement, if the circumstances warrant it, that the Applicant "has discharged his duties with

#H

of the Colony.

Yes.

11. Whether the duties of the several oflices or situations held since the Applicant entered the lis

Service have 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 Publi

Money by Compensation, Half-pay or otherwise.

No.

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

diligence and fidelity, to the satisfaction of the Head Officer or Officers of his Departinent,” 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.

Duties discharged with diligence and fidelity and to my entire satis-

faction. Save generally, I am unacquainted with the circumstances attend-

ant on resignation.

DR. H. Barking,

No.

Acting Police Magistrate.

28/5/93.

14. Absence, beyond ordinary Vacation leave

Year.

Period of Absence.

Number of Days.

Cause of Absence.

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

18

From

To

I certify that the pension

which may

be paid to the Applicant

18

ያን

18

»

18

18

18

J

18

"

39

18

18

18

31

N 1 1.

15. Date of Cessation of Duty,

1st November, 1897.

16. Date of Cessation of Salary,....

1st. November, 1897.

17. Date from which, inclusively, Pension will commence,... 1st. November, 1897.

according to the Rules of the Colonial Service, amounts to One hundred and Ninety- four dollars and Twenty-nine Cents.

and 1 base my Certificate on the following calculation :-

Lernice,.

C.O.D. to 360

No 260 7 1898

yours Pension

12 yeme

30

60

years 11 $85266 = $194 32

:

R

Freasury

Instructions.

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