(2)
+
(3)
133
10. Whether each of the Appointments held by the Applicant has been on the Fixed Establish. 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
of the Colony. Each appointment has been on the fixed establishment excep the last which was a special appointment, "but may count for pension Y C.S.0.No.394 of 1889).
11. Whether the duties of the several offices or situations held since the Applicant entered the C Service has been such as to require that the holder should give his whole time to the Pub
Service. The whole of the applicant's time has been given to the Publi
Service.
12. Whether holding any other Public Appointment, or receiving or claiming to receive any Pal
Money by Compensation, Half-pay or otherwise.
None.
13. If any kind of Pension or other Allowance has been commuted under the Imperial Pensi Commutation Acts, 1869 and 1871, and annual amount of Pension or Allowance so commut
and the date of Commutation should be inserted.
None.
"
merit, and value, and labour of the services of the P'erson 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 with diligence and
fidelity to the satisfaction of the Head Officer of his Department.
14. Absence, beyond ordinary Vacation leave :--- None.
Year.
Period of Absence.
18
From
To
18
ON
"
18
12
19
18
متقاضی
11
11
13
"7
5)
18
#1
1)
18
13
}}
18
י
18
37
18
"
Number of Days.
Canse of Absonce.
Treasurer
19. Computation, by the Colonial Secretary, of the Pension, &c.
I certify that the Pension
Director of Public Works.
which may be paid to the Applicant
according to the Rules of the Colonial Service, amounts to Two thousand eight hundred
and eighty dollars.
and I base my Certificate on the following calculation :-
Length of Service
Add (for climate)
Add (for professional qualification)
23 years 8months 24 days.
Ith
5
2
30 years 8 months 24 days.
15. Date of Cessation of Duty,
16. Date of Cessation of Salary,
31
21.2 January 1898
3
1st May 1898
Pension 30/80 of $5780 = $2880.
17. Date from which, inclusively, Pension will commence,...
14 June,
185
Bercanebith-
Treasurer.
Instructions.
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Private notes are available after approval.