(2)

10. Whether each of the Appointments held by the Applicant has been on the Fixed Establishment

of the Colony.

Yes.

11. Whether the duties of the several offices or situations held since the Applicant entered the Ci

Service have been such as to require that the holder should give his whole time to the Public

Service.

Yes.

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

Money by Compensation, Half-pay or otherwise.

e

Vo

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

No.

14. Absence, beyond ordinary Vacation leave, in each of the last 10 years :-

Y car.

Period of Absence.

To

18

From

18

})

>

18

""

};

18

18

18

*

A

>>

29

Nil

Number of Days.

Cause of Absence.

(3)

L.

35

18. Statement, if the circumstances warrant it, that the Applicant has discharge his duties with "diligence and fidelity, to the satisfaction of the Head Officer or Officers of his Department," to be signel 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 servies 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,

"

The

-applicant has discharged his duties with diligence and fidelity to my satisfaction

Mumaith mason

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

Harbour Master, &c.

I certify that the commuted compassionat allowance which raay be paid to the Applicant aceorling to the Rules of the Colonial Service, amounts to One hundred and forty nine dollars and thirty cents.

and I base my Certificate on the following ca'culation :—

Service.

24 year

Add

32

18

18

18

18

25

15. Date of Cessation of Duty...

16. Date of Cessation of Salary,

21st Cetober, 1898.

.31th Cctober, 1898.

17 Date from which, inclusively, Pension will commence,...

32 of $8400 = $4480

60

4/3 of $448 - $29 × 5 × $1494

Acting Treasurer.

Instructions.

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