1
ار
(C. 8. O. 1881] (C. 9. 86.)
C.O
27171
REC
REG 4 JUN 18
COLONIAL PENSIONS, &c.
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 4;
1. Name of Applicant Ahmaudar. Filencing. Churchite
2. Office or Situation....Fiel Araialant. Denator of Rubber works.
3. Recommended for
Cesaror...... months and...8.days..
1. Age... Hi. year..
....su
5. Service in Years and Months ..7.geara.
of $..
come...and.. 23. day.......
...F. become
512
6. Annual Salary or Wages
7. Emoluments...
actual.
Total amount of Salary or Wages and Emoluments on which Superannuation, &o, is claimed,
S. Cause of Retirement....
Ill beard
$£750..
• $750.-
9. Dates of Commencement and Termination of the several Appointinents held by Applicant, with
their Emoluments, distinguishing Salary from other Allowances and specifying such Allowances.
Title of Appointment,
Frist Assistant
Date of
Date
Annual Allowances, Commenec-
of ment. Termination. Salary,
&e,
Dindor of Public Works. 27. 11. 10. 26.11.131 £720
Do.
Do.
27. n. 13 26.4. 16. 6735:
27.
11. 16 19.2.18. £750..
1. O. D. No. }]
Nature of Allowances,
&c.
:
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