233

(2)

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

of the Colony.

fet

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.

Jes.

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

Money by Compensation, Half-pay or otherwise.

No.

13. If any kind of Pension or other Allowance has been commuted under the Imperial Pensions Commutation Acts, 1809 and 1871, and annual amount of Pension or Allowance so commutel

and the date of Commutation should be inserted.

No.

14. Absence, beyond ordinary Vacation leave:-

(3)

18. Statement, if the circumstances warrant it, that the Applicant "bas 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 Cfficers, 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, Repr'mand, &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 Pensiou, &c.

Year.

Period of Absence

Number of Days.

Cause of Absence.

1854. From 24 July

To oct

1888

27 April

N

31 Joxe

99 249

On half-pay leave

I certify that the according to the Rules of the Colonial Service amounts to and I base my Certificate on the following calculation:- -

which may

be paid to the Applicant

18.89

1892

1 January 429 July

18 Mar.

77

.8 Oct

72

1895

2:

1896

1896

*

6 July 1 January July

31020

189.6.

53

1

}}

1

}}

ingat 217

15 Auguer 30 NOV.

15. Date of Cessation of Duty, 30. //.

16. Date of Cessation of Salary,

8

1896

# 1896

(Drausferred to House

Cint Sawice er

americe whe

Prison Beurce 1.12.96

179

118

・on leave without

The applicant is entitled to draw his pension at the rate of Contribution to Widows' and Orphans' Pensions at the rate of

day of annum should be deducted, up to the......

per

19

. inclusive,

and the full amount of the pension should thereafter be paid.

Colonial Treasurer,

Governor, ģe,

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

[Instructions.]

FT

:

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