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THE NEW ZEALAND GAZETTE.
[No. 4

head of the Department in which he is re-employed to immediately
report the same to the Secretary to the Board, giving full particulars as
to such re-employment (date, remuneration, &c.).

23. Any contributor appealing to the Board under section 33 of the
    Act shall forward at least twenty-one days before the next ensuing
    quarterly meeting of the Board full particulars of his case in writing,
    addressed to the Secretary to the Board, and may, subject to the consent
    of the Board, appear in person before the Board in support of his case.
    The Board shall have full power to call for the production of all papers
    necessary in connection with a case.

24. Every notice of intention to retire from the Public Service under
    section 35 of the Act shall be forwarded in writing through the head of
    the Department in which the contributor is employed.

25. The head of every Department shall forthwith notify the Secretary
    to the Board of all applications received by him for voluntary retirement,
    and of all cases where a Minister is retiring a contributor, whether by
    reason of age or infirmity, and also of the death, resignation, or
    dismissal of a contributor; and such notice shall contain any terms and
    conditions as to payments into the Fund or otherwise imposed upon the
    retiring contributor by the Minister.

26. All such notices shall be sent in in the form set forth below :—

The Public Service Classification and Superannuation Act, 1908.

NOTICE OF RETIREMENT.

Contributor's name :
Department :
Position therein :
Cause of retirement or of leaving the service :*
Date of retirement :
Annual rate of salary at date of retirement :
Average annual rate of salary during three years precedent to date of retirement,
showing periods paid at different rates :
What compensation (if any) has been paid or is payable under the Workers' Com-
pensation Act, 1908 :
If contributor retiring by reason of infirmity, state—
(a.) If you have any reason to believe that such state has been caused by irregular
or intemperate habits :
(b.) Whether he is suited for other employment in the Government service, and, in
your opinion, of what nature :
I do hereby certify that to the best of my knowledge and belief the above particu-
lars are true and correct in every respect.

[Signature of head of Department.]
[Date.]

BENEFITS OF THE FUND.

27. The Secretary shall furnish the Board with a report upon the case
    of every contributor claiming on the Fund, and such report shall contain
    the following information, viz. :—

Name of contributor ;
Position in the Service ;
Age ;
Cause of retirement ;
Date of retirement ;
Length of service ;
Total amount contributed to Fund ;
Annual salary at retirement ;
Average salary on which retiring-allowance is to be computed under
section 39 ;
Amount of retiring-allowance to which entitled ;
Amount of payments (if any) from the Fund ;
Particulars of moneys (if any) due under section 32.

28. He shall similarly, so far as the circumstances apply, advise the
    Board with respect to contributors who retire “medically unfit,” or before
    becoming entitled to a retiring-allowance, or whose services are dispensed
    with. And in respect of every person whom it is proposed to retire as
    “medically unfit” there shall be produced two medical certificates in
    the form hereinafter following, each signed by a medical practitioner
    approved of by the Board.

The Public Service Classification and Superannuation Act, 1908.

PHYSICAL EXAMINATION OF CONTRIBUTOR APPLYING TO BE RETIRED AS MEDICALLY
UNFIT.

Name of contributor in full :
Residence :

1. Department of Service and position therein :
2. Age last birthday :
3. Weight and height of contributor :

• If contributor's age is less than sixty-five it should be here stated whether the
  Minister has extended the provisions of section 35 to his case, and, if so, upon what
  terms and conditions (if any).