402
THE NEW ZEALAND GAZETTE.
No. 9

(3.) The conditions of section 8 of the principal Act as amended have been complied with [or, as the case may be, have not been complied with in so far as relates to paragraph __ of that section].

Decision.—For the year commencing on the 1st day of __, 19, the pensioner is hereby granted a pension of £, payable at the Post-office at __ [or, as the case may be, is refused a pension].

Dated at __, this __ day of __, 19____.
, Stipendiary Magistrate.

Noted in Old-age Pension Register.—[Initials of Registrar.]

Renewal of warrant under section 42 required in favour of P.C. __ and warrant issued to __, : : , 19____.

——

[Form 22A (Reg. 47).]
Under the Old-age Pensions Acts, 1908 and 1909.
Under Regulation 47.

Pension No. __. Name: __.

The difference between the amount of property owned this year and the amount of property owned in the previous year is explained as follows:—

Date: __, 19____.
, Registrar, District.

——

[Form 23 (Reg. 52).]
Under the Old-age Pensions Acts, 1908 and 1909.

NOTICE OF ORDER OF COURT.

To the Registrar for the __ Old-age Pension District.

Pension-certificate No. __.

Name of Pensioner: __.

I HEREBY give you notice that at the Court held at __ on the __ day of __, 19____, the following order was made in respect of the above-mentioned pension-certificate [or, as the case may be, the following conviction was recorded]:—

. [Set out full particulars, giving reason of order or conviction.]

, Stipendiary Magistrate.

Date: __, 19____.

Noted in the Old-age Pension Register, and forwarded to the Commissioner at Wellington.

, Registrar.

——

[Form 24 (Reg. 59).]
Old-age Pension District.

RETURN OF PENSION-CLAIMS ESTABLISHED

During the month of __, 19____.

(To include transfers into district, so that numbers may be consecutive.)

Date: __, 19____.
, Registrar.

[This return is to be rendered monthly. If no pensions granted or transferred into district, a return marked “Nil” is required.]

——

[Form 24A (Reg. 59).]
Old-age Pension District.

RETURN OF ORIGINAL CLAIMS REJECTED, ADJOURNED, OR WITHDRAWN

During the month of __, 19____.

[NOTE.—Form 5 is required for each case rejected, postponed, or not gone on with.]

Date: __, 19____.
, Registrar.

[This return is to be rendered monthly. If no applications, a return marked “Nil” is required.]

——

[Form 24B (Reg. 59).]
Old-age Pension District.

RETURNS OF APPLICATIONS FOR RENEWAL, ADJOURNED OR REJECTED,

During the month of __, 19____.

[NOTE.—Form 22 is required for each case of rejection.]

Date: __, 19____.
, Registrar.

[This return is to be rendered monthly; and if no applications, a “Nil” return is required.]

——

[Form 25 (Reg. 60).]

[This form is to be supplied in the case of every death over the age of sixty-five, whether of a pensioner or not.]

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

NOTICE OF DEATH.

To the Commissioner of Old-age Pensions, Wellington.

I HAVE to advise you that I have received notice of the death of __, who died on the __ day of __, 19, aged __, and that he [she] was an old-age pensioner in the __ Old-age Pension District.

Dated at __, this __ day of __, 19____.
, Registrar of Deaths.

——

SECOND SCHEDULE.

REGULATIONS REVOKED.

REGULATIONS made under the Old-age Pensions Act, 1898, and its amendments, on the 13th day of February, 1903; on the 11th day of May, 1905; on the 22nd day of May, 1905; on the 6th day of December, 1905; and on the 29th day of April, 1907, respectively.

As witness the hand of His Excellency the Governor, this twenty-fourth day of January, one thousand nine hundred and ten.

D. BUDDO,
For Minister of Finance.