(2)
(3)
17
10. Whether each of the Appointments hell by the Applicant has been on the Fixed Establishus. Statement, if the circumstances warrant it. that the Applicant has disclorge his duties with
of the Colony.
Ifes
11. Whether the duties of the several offices or situations held since the Applicant entered the Civ
Service have been such as to require that the holder should give his whole time to the Pub Service.
Yes
12. Whether holding any other Public Appointment, or receiving or claiming to receive any Publi
Money by Compensation, Half-pay or otherwise.
No.
13. If any kind of Pensiou or other Allowance has been commuted under the Imperial Pensions Com mutation Acts, 1869 and 1871, and annual amount of Pension or Allowance so commuted an the date of Commutation should be inserted.
No
14. Absence, beyond ordinary Vacation leave, in each of the last 10 years :--
Year.
Period of Absence.
Number of Days.
Cause of Absence.
1898
From March to 30th April.
61
Ill health
18
31
B
18
18
Jy
18
72
18
18
18
18
23
>>
15. Date of Cessation of Duty.........
16. Date of Cessation of Salary,
ولار
31
*
17 Date from which, inclusively, Pension will commence,......
30th April, 1898.
30th April, 1898.
14
1th May, 1898.
diligence and fidelity, to the satisfaction of the Heal Officer or Ulfi ers of is Depatury..“ to be signe by any two of such Heal O.ficers, if there shall be more than one, or by x 13't Head Officer, if there shall be but one, together with such a statement as will exhibit the
i
14
merit, and value, and labour of the services of the Person recommended, embracing as long a
criod 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.
Mr. Hp Lany
mar
Las discharged his
duties mitt liligence and fillite
mysalisfaction.
19. Computation, by the Colonial Treasurer, of the Pension, &c.
I certify that the
Pension.
according to the Rules of the Colonial Service, amounts to and two dollars
and I base my Certificate on the following calculation :--
Length of Service Less 1/1⁄2 of t/1⁄2 pay leave_
39
Add
妈
which may be paid to the Applicant
Seven hundred
years mouths
34
8
34
7
39
Pension 22 of $1080 - $702 ×5. $3510 (Commuted 5
=
Mamoon
5 years)
Acting Treasurce
Instructions.
L
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