392
THE NEW ZEALAND GAZETTE.
[No. 9

2. The applicant’s income for last year was £
   . The applicant’s husband’s [wife’s] income was £
   . Total incomes of husband and wife: £
   . Deduction on account of income in excess of £34: £
   . Deduction in terms of section 15, (b): £
   .
3. The gross value of applicant’s property is £
   . Less property to be transferred to Public Trustee: £
   . Making the net value of property £
   . The gross value of husband’s [wife’s] property is £
   . Less mortgage at present date: £
   . Making the net value of property: £
   . Total net property of husband and wife: £
   . Deduction on account of property, being £1 for every £10 in net value: £
   .
   [NOTE.—If claimant is married, see section 15, (a).]

Decision.—Subject to the transfer to the Public Trustee of the property hereinbefore described, for the twelve months commencing on the 1st day of
, 19
, the applicant is granted a pension of £
(
day of
, 19
, Magistrate.

Noted in Pension-claim and Old-age Pension Registers.—
[Initials of Registrar.]

Particulars to be supplied by Registrar.

• Nature of proof of age:
  . Date of birth:
  . Nationality [If naturalised, give date]:
  . Name of husband [wife] [If not married, state conjugal condition and sex]:
  . Required only in the case of an original claim.

Husband’s [wife’s] pension No.
. Paying Office:
.

The Commissioner, Old-age Pensions.
The property hereinbefore described has been transferred [or conveyed] to me, and payment of the pension granted may be authorised.
Date:
, 19
. , Public Trustee.
P.C. No.
and warrant issued to
, 19
.

——

[Form A (Reg. 6).]
[This form is to be used where the applicant is unable to produce documentary evidence of age or naturalisation, or where date of arrival is required to assist in proving residence.]

Under the Old-age Pensions Acts, 1908 and 1909.

NOTES FOR REGISTRARS.

ALL official information, whether required from New Zealand, Australia, London, or elsewhere, must be obtained through the Commissioner.
Evidence of age is obtainable, through the Commissioner, from the records of the following events:—
(1.) Birth or marriage in New Zealand, Australia, or elsewhere.
(2.) Birth of child in New Zealand since the 1st January, 1876, or in Australia at any time.
(3.) Arrival at any port in New Zealand since the 1st January, 1871.
(4.) Arrival at Lyttelton or New Plymouth before 1871.
(5.) Arrival in Australia, and departure from Australia for New Zealand.
(6.) Naturalisation in New Zealand.
(7.) Enlistment in military or other forces in New Zealand, Australia, or elsewhere.

When all sources in New Zealand or Australia fail, the High Commissioner for New Zealand in London is asked to exhaust all sources of information open to him in the United Kingdom and Europe, such as official and parish registers of births, baptisms, and marriages, census returns, War Office records, &c.

The record of marriage, or birth of child, in New Zealand will assist in proving residence.

Claim No.
. Name:
.

The Commissioner, Wellington.
Application for pension having been lodged by the above-named, please obtain,—
(1.) Certificate of age.
(2.) Verification of date of arrival.
(3.) Evidence of naturalisation.
} [Delete where necessary.]

Particulars herewith to assist search:—
Birthplace: [Town or parish and county].
Stated date of birth:
. Father’s full name:
. Mother’s full maiden name:
. Religious denomination of parents:
. Port of arrival in New Zealand:
. Date:
. Name of ship, and captain’s name:
. Port of arrival in Australia:
. Date:
. Name of ship, and captain’s name:
. Place of marriage:
. Date:
. Full name of husband [wife]:
. Full maiden name of wife:
. Full name of child born in New Zealand (since 1st January, 1876):
. Birthplace of child born in New Zealand:
. Date of birth of child born in New Zealand:
. [NOTE.—The record of birth of child will assist in proving residence of the applicant.]

Date and place of naturalisation in New Zealand:
. Name of regiment, and regimental No.:
. , Registrar at
. Date:
, 19
.

——

Confidential.]
[Form B (Reg. 6).]
[This form must be used before the claim is submitted to the Magistrate.]
[To be sent to each bank in the district.]

Under the Old-age Pensions Acts, 1908 and 1909.
From the Registrar, Old-age Pensions,
, to the Manager, Bank of
,
. Claim No.
. Full name, occupation, and address:
. Full name of husband [wife]:
. As the person named above has made application for a pension [or is drawing a pension] under the above-named Acts, I shall be obliged if you will supply, in the spaces set apart hereunder, particulars of any money or securities deposited in your bank in the names of the applicant and the applicant’s husband [wife].
Date:
, 19
. , Registrar.

Extract from the “The Old-age Pensions Act, 1908.”
Section 22. (2.) It shall be the duty of every person to make true answers to all questions concerning any applicant for a pension or pension-certificate, or any of the statements contained in any application for a pension or pension-certificate, put to him by the Registrar, or any officer authorised in that behalf by the Registrar.
(3.) Every person commits an offence who—
(a.) Refuses to answer any such question; or
(b.) Makes any answer knowing the same to be untrue.
(4.) This section shall apply to any officer of any bank or other corporation carrying on business in New Zealand, and to any officer of the Post-Office Savings-Bank and of any other Government Department which receives investments of money from the public.

To the Registrar, Old-age Pensions,
Particulars herewith as requested:—

Date:
, 19
. , Manager.