CO129-447 - Governor Sir May - 1918 [1-3] — Page 272

[C. S. O. H (C. 8. 86.)

21228

REC

REG MAY 18

COLONIAL PENSIONS, &c.

267

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 ·

1. Name of Applicant W. V. M. Koch.

2. Office or Situation

3. Recommended for

1. Age..

Superintendent, bivil Hospital. Superannuation Allowance of 3.

...years.....

5. Service in Years and Months

6. Annual Salary or Wages

14.

4. years and 5 months.

$ € 420...

7. Emoluments..

Total amount of Salary or Wages and Emoluments on which Superannuation, &c, is claimed,

8. Cause of Retirement.

Age...

.$.....

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.

Date of Commence-

ment.

Date

of Termination.

Annual Allowances,

Salary

te.

Nature of Allowances,

&c.

Assistant surgeon, 3.5.03 1.9.04 480. redical Officerts Victoria Fast 2.9.04 25.10.04 480. Assistant Surgeon, 26.10.04 15.3.05 480. edical Officer to Victoria Fall, to, 16. 3.05 31.8.05 480

int inperintendant, bivil Hoop 1.9.06 2.5.06: 480 $0.

Free quarters.

#

Conveyance allowance

3. 5.06 31.12.04 1. 1.08 34.12.10

5720 600

"

4

#

་་

"

!

tq

111|31.12.13 1.1.14|22.12.14

640

680

ut, bivil Hospital, 23.12.14 31.12.16

Superintendent,

"

#

1.1.14 29.10.17 720

680

£36. Supt. 7 Zematic

Asylium.

"