[C. S. O. H (C. 8. 86.)
21228
REC
REG MAY 18
COLONIAL PENSIONS, &c.
267
PARTICULARS required to be furnished in reference to Persons recommended for
Superannuation, Compensation or Compassionate Allowances, or Gratuities on retirement.
(In filling up this Paper refer to the Instructions on page ·
1. Name of Applicant W. V. M. Koch.
2. Office or Situation
3. Recommended for
1. Age..
Superintendent, bivil Hospital. Superannuation Allowance of 3.
...years.....
5. Service in Years and Months
6. Annual Salary or Wages
14.
4. years and 5 months.
$ € 420...
7. Emoluments..
Total amount of Salary or Wages and Emoluments on which Superannuation, &c, is claimed,
8. Cause of Retirement.
Age...
.$.....
9. Dates of Commencement and Termination of the several Appointments held by Applicant, with
their Emoluments, distinguishing Salary from other Allowances and specifying such Allowances.
Title of Appointment.
Date of Commence-
ment.
Date
of Termination.
Annual Allowances,
Salary
te.
Nature of Allowances,
&c.
Assistant surgeon, 3.5.03 1.9.04 480. redical Officerts Victoria Fast 2.9.04 25.10.04 480. Assistant Surgeon, 26.10.04 15.3.05 480. edical Officer to Victoria Fall, to, 16. 3.05 31.8.05 480
int inperintendant, bivil Hoop 1.9.06 2.5.06: 480 $0.
Free quarters.
#
Conveyance allowance
3. 5.06 31.12.04 1. 1.08 34.12.10
5720 600
"
4
#
་་
"
!
tq
111|31.12.13 1.1.14|22.12.14
640
680
ut, bivil Hospital, 23.12.14 31.12.16
Superintendent,
"
#
1.1.14 29.10.17 720
680
£36. Supt. 7 Zematic
Asylium.
"