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18

APPENDICES.

APPENDIX A. Old-age Pensions Act. Pension-claim No. , District. Minute op Magistrate's Decision. I find the applicant, , has proved the matters set out hereunder:— (a.) Has fulfilled the conditions as to residence and age. (b.) Is not disqualified by reason of any of the matters mentioned in subsections (3), (4), (5), and (9) of section 8. (c.) Fulfils the condition of subsection (6) of section 8. (d.) The applicant's yearly income did not amount during the past income-year to more than £ (c.) The net capital value of the applicant's accumulated property does not amount to more than £ (/.) The applicant is entitled to a pension of Dated this day of , 19 . , Stipendiary Magistrate.

APPENDIX B. Pension-claim No. [This form is issued for use of Magistrates when investigating claims.] What is your name ? What is your occupation ? Where were you born ? If foreigner, have you a naturalisation certificate ? How old are you ? What proof have you of your age ? When did you arrive in New Zealand ? What proof have you of this ? Have you been absent from New Zealand since your first arrival? If so, on what occasions ? Are you married? If so, is your wife [husband] alive ? Are you living together ? If not, what are the circumstances ? What certificates have you of character ? Have you ever been charged with any offence ; if so, state the facts ? What are your means of living ? Have you or wife [husband] any— (a.) Property ? (b.) Money? (c.) Income ? If you have, what is the value? (Produce particulars and valuation.) Have you transferred any property within the last years ? Other Evidence.

APPENDIX C. Reinvestigation Old-age Pensions granted in 1899.—District of

Approximate Coat of Paper. —Preparation, not giveu; printing (1,200 copies), £10.

Price 6d.] By Authority : John Maokay, Government Printer, Wellington.—l9ol.

No. Name. Address. Date 1898 - of Pension. In- Procome, perty. I . co 1899. In- P Dme. pe Amount of Pension. Monthly Instalment. 1899: Where Payable. 1900: Where Payable. Date of Hearing and Decision of the Magihfcrate, and Remarks. In- Procome, perty.

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