C
(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 Civi 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.
ho.
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 commuteď
and the date of Commutation should be inserted.
C
(3)
268
18. Statement, if the circumstances wanant 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 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.
The Applicant has discharged his duties to the satisfaction of the Head of his Department-
I. M. Johnson
Pri wa Eu Me You Offica
4.10.17
ho.
14. Absence, beyond ordinary Vacation leave:—
19. Computation, by the Colin Treasurer, of the Pension, &e.
I certify that the
Om Half lay Leave
do
according to the Rules of the Colonial Service amounts to
and I base my Certificate on the following calculation:--
Year.
Period of Absence
Number of Days..
Cause of Absence.
19.10. From
16.2.10
To 30-11-10
19.43
19.0.3..
21. 4.13
» 12-11-13
9 6222
14
30
-
3.
5. 03
· 5.03
9 days
"}
1
"
1
"
37
1
15
1
1 ......
1
1
"
*
>>
**
15. Date of Cessation of Duty...30th August 191.7
16. Date of Cessation of Balary,..
29th October 1917
30th
37. Date from which, inclusively, Pension will commence, 30 October 1914.
which may be paid to the Applicant
The applicant is entitled to draw his pension at the rate of Contribution to Widows' and Orphans' Pensions at the rate of
Aunum should be deducted, up to the....
per
day of
19
inclusive,
and the full amount of the pension should thereafter be paid.
Colonial Treasurer.
Ama
Governor, &c,
[Instructions.]
.