31
(In filling up this paper refer to the instructions on the next page.)
1. Name of applicant
2. Office or situation
3. Recommended for
4. Age
5. Service in years and months.
6. Salary or wages (
7. Emoluments
of £.
}
£
KUO
Total amount of salary or wages and emolumente, on which superannua-
tion, etc., is claimed
£
8. Cause of retirement.
9. Dates of commencement and termination of the several appointments held by applicant, with their emoluments, distinguishing salary from other allow-
ances, and specifying such allowances :—
Title of Appointment.
Date of
Commence.
ment.
Date of
Termina.
tion.
Salary.
Allow.
ances, &c.
Nature of Allowances,
&c.
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 eutered the Civil Service have been such as to require that the holder should give his whole time to the public service.
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 Com- mutation Acts, 1869 and 1871, the annual amount of pension or allowance so commuted, and the date of commutation, should be inserted.
19
PUBLIC RECORD OFFICE
Reference :-
C.O-885
17 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH-NOT TO
31
(In filling up this paper refer to the instructions on
the next page.)
1. Name of applicant
2. Office or situation
3. Recommended for
of £
4. Age
5. Service in years and months.
6. Salary or wages (
>
£
7. Emoluments
Total amount of salary or wages and emoluments, on which superannua- tion, etc., is claimed
£
8. Cause of retirement.......
9. Dates of commencement and termination of the several appointments held by applicant, with their emoluments, distinguishing salary from other allow- ances, and specifying such allowances :—
Title of
Appointment.
Date of
Commence-
ment.
Date of
Termina-
tion.
Salary.
Allow-
ances, ko.
Nature of
Allowances, .
&C.
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 public service.
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 Com- mutation Acta, 1869 and 1871, the annual amount of pension or allowance so commuted, and the date of commutation, should be inserted.
། :། ། :། །
PUBLIC RECORD OFFICE
וי
C.O.
Reference :-
•885
COPYRIGHT
17 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
PHOTOGRAPH-NOT TO
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