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

Loo

11. Whether the duties of the several offices or situations held since the Applicant entered the Civil Service have been such as to require that the holder should give his whole time to the Public Service.

Yoo.

12. Whether holding any other Public Appointment, or receiving or claiming to receive any Public Money by Compensation, Half-Pay or otherwise.

ho.

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

20.

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

"with 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.

Year. Period of Absence. Number of Days Cause of Absence. 1893 From G2 3*** To 1896 1897 19 18 JA 18 18 1901 18 18 July 20th 12 22

15. Date of Cessation of Duty March 20th 1907.

16. Date of Cessation of Salary

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

19. Computation, by the Auditor-General, of the Pension, &c.

I certify that the ... which may be paid to the Applicant according to the Rules of the Colonial Service, amounts to ... and I base my Certificate on the following calculation:

Instructions

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