316
(2)
10. Whether each of the Appointments held by the Applicant has been on the Fixed Establishment
of the Colony.
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 Publie Service.
(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 bis public service as can be authentically stated," and observations as to Special Services, Suspensien, Reprimand, &c, with full particulars of try injuries received on duty or other claims or matters for consideration,
12. Whether holding any other Public Appointment, or receiving or claiming to receive any Public
Money by Compensation, Half-pay or otherwise.
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.
Period of Absence
Number of Days.
1913...
*
From 20.8.13
To 17.3.14 13 mons.
Cause of Absence.
Commuted into 6' months full pay
eave.
"
Half of Half-
1919
23.1.19
1:
15.8.19 15 mons.
Commuted into 70 months full pay leave.
-pay leave...
¥
1919..
1
Net service 6 years
ララ
19. Compulation, by the Colonial Treasurer, of the Pension, &c.
which
may
be paid to the Applicant
8 11
•
4
I certify that the Pension. according to the Rules of the Colonial Service amounts to £100 and I base my Certificate on the following calculation:- Para.17(2)
Service..... .6 years 10 months O days
1
15
8 months 15 days i.e. 80 months
16.11.19
"
15.2.20 3 mons.
Half-pay leave.
Addition under (a)
(101)
i.e. 33
H
Pension is
90+33 £640 £100 8 11
1
Sy
1
1
1)
55
55
}
21
15. Date of Cessation of Duty,..........
16. Date of Cessation of Salary,...15th February, 1920.
17. Date from which, inclusively, Pension will commence,...
16th February, 1920.
720
The applicant is entitled to draw his pension at the rate of
}
per
19 46, inclusive,
Contribution to Widows' and Orphans' Pensions at the rate of £25. 125...
6th annum should be deducted, up to the.....
day of March
and the full amount of the pension should thereafter be paid.
(Sd.) C.Mol. Messer:
Colonial Treasurer,
Governor, &c.
[Instructions.]