610
(2)
10. Whether each of the Appointments held by the Applicant has been on the Fixel Establishment
of the Colony.
His first appointment was purely temporary & provisional.
His subsequent appointments have not been confirmed by the Secretary of Stat 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.
Doubtful-
12. Whether holding any other Public Appointment, or receiving or claiming to receive any Public
Money by Compensation, Half-pay or otherwise.
C
(3)
18. Statement, if the circumstances warrant it, that the Applicant "has 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.
No
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:-
No
Period of Absence.
Number of Days.
Cause of Absence.
19. Computation, by the Colonial Secretary, of the Pension, &c.
I certify that the
according to the Rules of the Colonial Service, amounts to
which may
be paid to the Applicant
Year.
18
From
To
18
18
י
18
18
74
18
,,
*
18
}}
"
18
#2
25
19
31
25
18
"
"}
15. Date of Cessation of Duty,
16. Date of Cessation of Salary,
17. Date from which, inclusively, Pension will commence............
and I base my Certificate on the following calculation :
Resident Service =
15 years
Add for climate
5
Addition under clause
111(2) of the Pension
*
minute.
Total pensionable
23
23 2880
= $1104.
80
1
33
6.
Instructions.
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