(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 Civil 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.

Yes.

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

and the date of Commutation should be inserted,

14. Absence, beyond ordinary Vacation leave:--

Year.

1597. From

1894..)

1

1

+3

Period of Abuener

9.3.

No

اکھ

Number of Daya.

Cause of Absence.

·

To $-/-/5$8.

30 month

15

9.10.1894. 7 $1 months.

כן

months]

Stalf pay have

(3)

280

18. Statement, if the circumstances warrant it, that the Applicant "has discharged his duties 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, togther 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 this 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.

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

pension

Whath.

bucctor

of

Public Maks

which may be paid to the Applicant

I certify that the

according to the Rules of the Colonial Service, amounts to

and I base myCertificate on the following calculation:-

Total length of service,

Less half of half pay have.

Thonths. bays.

173.

22

109.

22

9

2-

141 $6660 = $1304435-

710

741

=

£239.8.37

1

1

1

1

1

1

"1

13

11

23

申要

*2

>>

15. Date of Cessation of Duty, 7:5 1897, Transferred to beylon

16. Date of Cessation of Salary, 1018 19.13, in beylon.

17. Date from which, inclusively, Pension will commence,...:.& · 1973 ·

add for tropical allowance.

A.

offersones qualification

The applicant is entitled to draw his pension at the rate of 3d.

(* hebjel ti approved &

S. 98.) Contribution to Widows and Orpluna' Pensions nt the

mnum should be deducted, upisike

...day of...

wed the full amount of the pouch. Should thereafter le publ

bmag

Governor, &c.

Incrusive.

Fußtemen

Colonial Treasurer

[Instructions

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