CO129-390 - Acting Governor Claud Severn - 1912 [5-6] — Page 130

f

[C. S. O. 1858] A. 132.)

C. 0.

17903

125

GE 10 JUN 12

COLONIAL PENSIONS, &c...

PARTICULARS required to be furnished in reference to Persons recommended for Superannuation, Compensation or Compassionate Allowances, or Gratuities on retirement.

(In filling up this Paper refer to the Instructions on page 4,)

1. Name of Applicant...

2. Office or Situation

3. Recommended for..

A Age

5. Service in Years and Months

Love Mo

Andipan to sanitary Inspector

Pension

vab Eman

22 Jean and 9 mon

6. Annual Salary or Wages.

7. Emoluments

Total amount of Salary or Wages and Emoluments on which

Superannuation, &c., is claimed,

6. Cause of Retirement.

Old age

ཨེམ་tau---

$408

$

9. Dates of Commencement and Termination of the several Appointments held by Applicant, with their Emoluments, distinguishing Salary from other Allowances and specifying such Allowances.

Title of Appointment.

[C. O, D. No. 43]

Date of Commence- nout.

Date

Amual Allowances, of Termination. Salary.

Nature

of Allowances,

&c.

&c.

i

1.8.78 21.12.97 $240

ingrorugs. $300.

1-1-99 01-12-99. $212

0:21.12.00 $24

1.1.01 31-12-01

11.02

ماهرین گھر

$40 f