✨ Old-age Pensions Forms
394
THE NEW ZEALAND GAZETTE.
[No. 9
| Questions. | Answers. |
|---|---|
| 1. Where has applicant resided during the last twenty-five years? | |
| 2. Has applicant ever been absent from New Zealand? If so, give dates when absent | |
| 3. If applicant was absent from New Zealand for four or less years, has applicant, after deducting absences, resided for twenty-five years in New Zealand? | |
| 4. Has applicant during the last twenty-five years been imprisoned? If so, give particulars of offence and period of imprisonment | |
| 5. Has applicant during the last twelve years (if a husband) deserted his wife, or neglected to maintain her or any of his children under the age of fourteen years; or, if a wife, deserted her husband or such of her children as were under that age? | |
| 6. Is applicant of good moral character? | |
| 7. Has applicant been leading a sober and reputable life during the past twelve months? | |
| 8. Has the applicant been working during the past twelve months? | |
| 9. Has the applicant's wife [or husband] been working during past twelve months? | |
| 10. State name and address of employers in each case | |
| 11. Does applicant own land, houses, money, stock, furniture, or other property? If so, state value and where located, and amount of income derived therefrom | |
| 12. Does applicant's wife [or husband] own land, houses, money, stock, furniture, or other property? If so, state value and where located, and amount of income derived therefrom | |
| 13. Does applicant permanently reside on own property; or that of wife [or husband]? | |
| 14. Does the property on which applicant permanently resides produce income? | |
| 15. Has applicant or applicant's husband [or wife] disposed of property or income at any time? | |
| 16. If applicant does not work, and owns no property, and wife [or husband] likewise, with whom does applicant live? State whether the applicant pays rent or lives with relatives |
Report generally as to qualification for the pension:—
[Form F (Reg. 6).]
[This form is to be used where necessary in connection with property quoted on Form C.]
Under the Old-age Pensions Acts, 1908 and 1909.
From the Registrar of Old-age Pensions, , to the District Land Registrar or Registrar of Deeds, .
Claim [or Pension] No. .
Name: .
Name of wife [husband]: .
I SHALL be obliged if you will inform me what interest (if any) is or has been held at any time in the undermentioned property or mortgage by the applicant or applicant’s husband [wife]. If the property or mortgage is or has been owned as stated, please supply details and dates of any transactions registered against the title.
| Description. | Area. | Freehold or Leasehold. | Stated to be owned by | Deeds Reg. No. |
|---|---|---|---|---|
| A. R. P. |
Date: , 19 . , Registrar.
[NOTE.—The books of the various District Land Registrars are kept at Wellington, Auckland, Gisborne, New Plymouth, Napier, Blenheim, Nelson, Hokitika, Christchurch, Dunedin, and Invercargill.]
Report herewith. , District Land Registrar [or Registrar of Deeds].
Date: , 19 .
[Form G1 (Reg. 6).]
[This form must be used before the claim is submitted to the Magistrate.]
Under the Old-age Pensions Acts, 1908 and 1909.
From the Registrar, Old-age Pensions, at , to .
Name: .
Occupation: .
Address: .
As the person named herein has made application for a pension [or is drawing a pension] under the above-named Acts, I shall be glad to know, for the information of the Magistrate, what wages, allowance, or assistance he received from you during the past twelve months ended 19 .
Kindly complete and return this form to me as speedily as possible, as no pension can be granted until the information is supplied, and any delay may cause inconvenience to the applicant.
Date: , 19 . , Registrar.
Extract from “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.
To the Registrar, Old-age Pensions, at .
During the twelve months ended , 19 , Mr. received from me the sum of £ .
- This sum was in addition to free board and lodgings.
Date: , 19 . [Signature.]
- Delete where necessary.
[Form G2 (Reg. 6).]
[This form must be used before the claim is submitted to the Magistrate.]
Under the Old-age Pensions Acts, 1908 and 1909.
From the Registrar, Old-age Pensions, at , to .
Name: .
Occupation: .
Address: .
As the person named herein has made application for a pension [or is drawing a pension] under the above-named Acts, I shall be glad to know, for the information of the Magistrate, what he received for [Insert gum, gold, milk, grain, or other produce, as the case may be] sold to you during the past twelve months ended , 19 .
Kindly complete and return this form to me as speedily as possible, as no pension can be granted until the information is supplied, and any delay may cause inconvenience to the applicant.
Date: , 19 . , Registrar.
Extract from “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.
To the Registrar, Old-age Pensions, at .
During the twelve months ended , 19 , Mr. received from me, for sold, cash (*and the equivalent of cash) to the value of £ .
I am not aware of his having sold elsewhere.
Date: , 19 . [Signature.]
- Delete where necessary.
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NZ Gazette 1910, No 9
✨ LLM interpretation of page content
🏥
Old-age Pensions Act - Information Request from Registrar to Police
(continued from previous page)
🏥 Health & Social WelfareOld-age pensions, Registrar, Police, Confidential inquiry, Applicant details
🏥 Form F - Property Inquiry for Old-age Pensions
🏥 Health & Social WelfareOld-age pensions, Property inquiry, Land registry, Mortgage details
- Registrar of Old-age Pensions
- District Land Registrar or Registrar of Deeds
🏥 Form G1 - Wages and Assistance Inquiry for Old-age Pensions
🏥 Health & Social WelfareOld-age pensions, Wages inquiry, Employment details, Magistrate review
- Registrar, Old-age Pensions
🏥 Form G2 - Produce Sales Inquiry for Old-age Pensions
🏥 Health & Social WelfareOld-age pensions, Produce sales, Income verification, Magistrate review
- Registrar, Old-age Pensions