To assist in the protection of the public against possible frauds, the Commission shall establish and keep in each State a Register of the Securities accepted in that State.
Register to be kept in office of Deputy Commissioner.
The Register in each State shall be kept in the office of the Deputy Commissioner for the State.
Particulars of securities to be entered in Register.
(1) As soon as practicable but not later than fourteen days after a security has been accepted, particulars of that security shall be entered in the Register.
(2) As soon as practicable but not later than fourteen days after a security has ceased to be in force an entry of that fact shall be made in the Register.
Form and contents of entries in Register.
The form and contents of entries to be made in the Register shall be determined from time to time by the Commission, but until otherwise determined by the Commission entries shall be made in accordance with Form E in the Schedule.
Searches.
(1) Any person shall be entitled to search the Register and make extracts therefrom on payment of a search fee of One shilling for each period of five minutes occupied in the search, or such search fee as is from time to time determined by the Commission.
Extracts from Register not to be published.
(2) No person, firm or company shall print, publish, sell or expose for sale, any book, periodical, pamphlet, circular, handbill, poster, or newspaper, containing any extract made from the Register.
Liability for entry in, or omission from, Register.
No liability shall be incurred by the Commonwealth or by the Commission, or by any officer of the Commonwealth by reason of any entry having been made in or omitted from the Register, or by reason of anything having been inserted in or omitted from any entry in the Register.
Inspection of documents.
Nothing in these Regulations shall entitle any person to inspect any security or any other document in the possession or under the control of the Commission.
Part XII.—Miscellaneous.
Power of Commission to enter into contracts.
The Commission may enter into contracts for any purpose connected with or incidental to the carrying out of the Act or these Regulations including contracts for the purchase or sale of any commodities.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="3" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Securities.</span></p></td><td colspan="6" style="border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Person Giving Security.</span></p></td><td rowspan="2" style="width:10.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Amount Secured.</span></p></td></tr><tr style="height:1pt"><td style="width:4.44%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">No.</span></p></td><td style="width:7.5%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Date.</span></p></td><td style="width:12.84%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Nature of Security.</span></p></td><td style="width:9.66%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Regtl. No.</span></p></td><td style="width:9.62%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Rank.</span></p></td><td style="width:10.34%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Unit.</span></p></td><td style="width:13.56%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Name in Full</span></p></td><td style="width:10.04%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Address.</span></p></td><td style="width:11.74%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Occupation.</span></p></td></tr><tr style="height:23.05pt"><td style="width:4.44%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.5%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:12.84%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.66%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.62%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.34%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.56%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.04%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.74%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:8.66%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Rate of Interest Payable.</span></p></td><td colspan="4" style="border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Repayment.</span></p></td><td colspan="2" style="border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Property over which Security Given.</span></p></td><td rowspan="2" style="width:9.56%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Remarks.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Security Discharged.</span></p></td></tr><tr style="height:1pt"><td style="width:12.74%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Instalments due. Monthly, &c.</span></p></td><td style="width:8.58%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Amount.</span></p></td><td style="width:11.44%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Repayable by.</span></p></td><td style="width:7.6%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Extended to.</span></p></td><td style="width:11.52%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Description of.</span></p></td><td style="width:8.54%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Where situated.</span></p></td><td style="width:10.68%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Date of Discharge.</span></p></td><td style="width:10.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Manner of Discharge.</span></p></td></tr><tr style="height:22.15pt"><td style="width:8.66%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:12.74%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.58%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.44%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.6%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.52%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.54%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.56%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.68%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:36.48%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Full Name of each Pensioner.</span></p></td><td style="width:15.98%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Fortnightly Amount Payable.</span></p></td><td style="width:17.98%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Altered from</span></p><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">/</span><span style="width:19.34pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">/ 192</span></p></td><td style="width:15.98%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Altered from</span></p><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">/</span><span style="width:19.34pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">/ 192</span></p></td><td style="width:13.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Altered from</span></p><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">/</span><span style="width:19.34pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">/ 192</span></p></td></tr><tr style="height:50.05pt"><td style="width:36.48%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:bottom"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Total</span></p></td><td style="width:15.98%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.98%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:15.98%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:13.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:normal"><span style="font-family:'Times New Roman', serif">Postmaster’s signature to each Alteration</span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:26.3pt"><td rowspan="4" style="width:335.7pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-left:14.4pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">The first instalment payable was due on “Pension Thursday”, the</span><span style="width:23.68pt; display:inline-block"> </span><span style="width:36pt; display:inline-block"></span><span style="font-family:'Times New Roman', serif">19</span><span style="width:25pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">, on which date the following amount became due:—</span></p><p style="margin-left:121.5pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Odd days from</span><span style="width:28.51pt; display:inline-block"> </span><span style="width:36pt; display:inline-block"></span><span style="font-family:'Times New Roman', serif">to</span><span style="width:27.44pt; display:inline-block"> </span><span style="width:36pt; display:inline-block"></span><span style="font-family:'Times New Roman', serif">£</span></p><p style="margin-left:121.5pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Fortnight in advance from</span><span style="width:15.33pt; display:inline-block"> </span><span style="width:36pt; display:inline-block"></span><span style="width:36pt; display:inline-block"></span><span style="font-family:'Times New Roman', serif">£</span></p><p style="margin-right:5.6pt; margin-left:111.6pt; margin-bottom:0pt; text-align:right; line-height:normal"><span style="font-family:'Times New Roman', serif">Total</span><span style="width:105.29pt; font-family:'Lucida Console', monospace; display:inline-block">...............</span><span style="font-family:'Times New Roman', serif">£</span></p></td><td style="width:118.55pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:15.35pt"><td style="width:118.55pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic"></span></p></td></tr><tr style="height:9.1pt"><td style="width:118.55pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic"></span></p></td></tr><tr style="height:9.05pt"><td style="width:118.55pt; border-top:0.75pt solid #000000; border-bottom:4.5pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic"></span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="3" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"><p style="margin-left:28.8pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">I hereby acknowledge receipt of War Pension Certificate numbered as above:—</span></p><p style="margin-left:57.6pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(</span><span style="font-family:'Times New Roman', serif; font-style:italic">signature</span><span style="font-family:'Times New Roman', serif">)</span><span style="width:1.52pt; display:inline-block"> </span><span style="width:36pt; display:inline-block"></span><span style="width:36pt; display:inline-block"></span><span style="width:36pt; display:inline-block"></span><span style="width:36pt; display:inline-block"></span><span style="width:36pt; display:inline-block"></span><span style="font-family:'Times New Roman', serif; font-style:italic">* Pensioner./* Trustee.</span></p><p style="margin-left:43.2pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic">Date</span></p></td></tr><tr style="height:1pt"><td style="width:67.3%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Payment to be made in future at—</span></p></td><td style="width:16.2%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">The Last Payment made at this Office was due on Pension Thursday, the—</span></p></td><td style="width:16.5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Signature of Postmaster and Office Stamp.</span></p></td></tr><tr style="height:1pt"><td style="width:67.3%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.2%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">/</span><span style="width:12.29pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">/ 192</span></p></td><td style="width:16.5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:67.3%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.2%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic">/</span><span style="width:12.29pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif; font-style:italic">/</span><span style="font-family:'Times New Roman', serif"> 192</span></p></td><td style="width:16.5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:67.3%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.2%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">/</span><span style="width:12.29pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">/ 192</span></p></td><td style="width:16.5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:47.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Full name of each pensioner.</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Fortnightly amount payable.</span></p></td></tr><tr style="height:47.05pt"><td rowspan="2" style="width:47.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic">£</span></p></td><td style="width:3.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic">s.</span></p></td><td style="width:2.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic">d.</span></p></td><td rowspan="2" style="width:25.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:23.45pt"><td style="width:3.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic"></span></p></td><td style="width:3.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic"></span></p></td><td style="width:2.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-style:italic"></span></p></td></tr><tr style="height:1pt"><td style="width:47.62%; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-left:198pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Total</span><span style="width:111.79pt; font-family:'Lucida Console', monospace; display:inline-block">................</span></p></td><td colspan="5" style="border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:31.94%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Name and Address of Pensioner or Claimant.</span></p></td><td colspan="2" style="border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Regimental Particulars.</span></p></td><td style="width:14.44%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif; font-variant:small-caps">“C” F</span><span style="font-family:'Times New Roman', serif">ile No.</span></p></td><td style="width:29.16%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Specimen Signature of Pensioner or Claimant.</span></p></td></tr><tr style="height:61.75pt"><td style="width:31.94%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.44%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:29.16%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" rowspan="3" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">War disabilities in respect of which pension is * granted /* applied for.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="3" style="border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(</span><span style="font-family:'Times New Roman', serif; font-style:italic">a</span><span style="font-family:'Times New Roman', serif">)</span></p></td></tr><tr style="height:1pt"><td colspan="3" style="border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(</span><span style="font-family:'Times New Roman', serif; font-style:italic">b</span><span style="font-family:'Times New Roman', serif">)</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(</span><span style="font-family:'Times New Roman', serif; font-style:italic">c</span><span style="font-family:'Times New Roman', serif">)</span></p></td></tr><tr style="height:0pt"><td style="width:155.1pt"></td><td style="width:84.3pt"></td><td style="width:34.5pt"></td><td style="width:70.15pt"></td><td style="width:141.6pt"></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:28.45pt"><td colspan="2" rowspan="7" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">8. Percentage of incapacity</span><span style="width:96.89pt; font-family:'Lucida Console', monospace; display:inline-block">..............</span></p><p style="margin:50pt 14.4pt 0pt 85.7pt; text-align:justify; line-height:normal"><span style="height:0pt; margin-top:-50pt; text-align:left; display:block; position:relative; z-index:11"><img src="image.009.png" width="11" height="57" alt="" style="margin-top:52.83pt; margin-left:132.57pt; position:absolute"></span><span style="font-family:'Times New Roman', serif; font-style:italic">These may be combined under one percentage if thought desirable by medical examiner</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-left:14.4pt; margin-bottom:0pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">He is at present incapacitated to the extent of</span><span style="width:18.08pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">% of total incapacity, made up as follows:—</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:15.85pt"><td style="width:45%; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-right:14.4pt; margin-left:57.6pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(1) Disability existing, pre-war (if any)</span><span style="width:5.43pt; text-indent:0pt; display:inline-block"></span></p></td><td style="width:5.1%; padding-right:2pt; padding-left:2pt; vertical-align:bottom"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">%</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:16.75pt"><td style="width:45%; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-right:14.4pt; margin-left:57.6pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(2) Disability caused through war service</span><span style="width:5.45pt; text-indent:0pt; display:inline-block"></span></p></td><td style="width:5.1%; padding-right:2pt; padding-left:2pt; vertical-align:bottom"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">%</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:16.3pt"><td style="width:45%; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-right:14.4pt; margin-left:57.6pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(3) Disability—aggravation caused by war service</span><span style="width:1.75pt; text-indent:0pt; display:inline-block"></span></p></td><td style="width:5.1%; padding-right:2pt; padding-left:2pt; vertical-align:bottom"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">%</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:11.9pt"><td style="width:45%; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-right:14.4pt; margin-left:57.6pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">(4) Present disability (if any) due to post-war causes, but not contributed to by service</span><span style="width:25.32pt; text-indent:0pt; display:inline-block"></span></p></td><td style="width:5.1%; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:bottom"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">%</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:5.35pt"><td style="width:45%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:6pt; margin-left:14.4pt; margin-bottom:6pt; text-indent:-14.4pt; text-align:right; line-height:normal"><span style="font-family:'Times New Roman', serif">Total, as above</span><span style="width:77.11pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">...........</span></p></td><td style="width:5.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"><p style="margin-top:6pt; margin-left:14.4pt; margin-bottom:6pt; text-indent:-14.4pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">%</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:5.3pt"><td colspan="2" style="border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-left:14.4pt; margin-bottom:0pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">N.B.—Any degree of incapacity due to the default or wilful act of the ex-member is not a pension liability.</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-left:14.4pt; margin-bottom:0pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">9. Nature of employment since discharge and time lost during past 12 months through war disabilities</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="border-bottom:0.75pt solid #000000; vertical-align:top"></td></tr><tr style="height:1pt"><td rowspan="2" style="width:45.22%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">For office use (G.O. 312 (2) ).</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:10pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">To the Deputy Commissioner of Repatriation,</span></p></td></tr><tr style="height:1pt"><td style="width:45.22%; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:6pt; margin-left:28.8pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Signature</span></p></td></tr><tr style="height:1pt"><td style="width:45.22%; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:6pt; margin-left:144pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Medical Examiner.</span></p></td></tr><tr style="height:1pt"><td style="width:45.22%; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Address</span></p></td></tr><tr style="height:1pt"><td style="width:45.22%; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Date</span></p></td></tr><tr style="height:0pt"><td style="width:219.6pt"></td><td style="width:17.7pt"></td><td style="width:218.55pt"></td><td style="width:24.75pt"></td><td style="width:5.05pt"></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:50.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Questions and requests for information.</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Replies.</span></p></td></tr><tr style="height:1pt"><td style="width:50.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">State your number, rank, and the regiment or branch of the Forces in which you served</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">No.</span><span style="width:21.28pt; display:inline-block"> </span><span style="width:36pt; display:inline-block"></span><span style="font-family:'Times New Roman', serif">Rank</span></p><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Regiment, &c.</span></p></td></tr><tr style="height:1pt"><td style="width:50.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin:3pt 14.4pt; text-indent:-14.4pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">State how, where and when your incapacity was caused</span><span style="width:2.58pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:50.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Where and when were you born? (Give name of town and country, also exact date, if known.)</span><span style="width:20.3pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Place</span></p><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date</span></p></td></tr><tr style="height:1pt"><td style="width:50.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">What was your occupation before the outbreak of war? (State name of employer and rate of earnings.)</span><span style="width:23.56pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:50.62%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">If you are or have been married, state, in respect of your first marriage:—</span></p></td><td style="width:13.86%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Full Maiden Name of Wife.</span></p></td><td style="width:10.7%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Place of Marriage.</span></p></td><td style="width:8.12%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Date of Marriage.</span></p></td><td style="width:8.2%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">If wife still living.</span></p></td><td style="width:8.5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Present Address</span></p></td></tr><tr style="height:59.95pt"><td style="width:50.62%; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:bottom"><p style="margin:3pt 14.4pt; text-indent:-14.4pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif">Give particulars of any subsequent marriage or marriages</span><span style="width:22.37pt; text-indent:0pt; display:inline-block"></span></p></td><td style="width:13.86%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.7%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:10pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:40.78%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Full Names of Children.</span></p></td><td colspan="2" style="border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Date of Birth.</span></p></td><td style="width:21.66%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Place of Birth.</span></p></td><td style="width:20.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-top:6pt; margin-bottom:6pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Where Living at Present.</span></p></td><td style="vertical-align:top"></td></tr><tr style="height:86.5pt"><td style="width:40.78%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.66%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:20.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="border-bottom:0.75pt solid #000000; vertical-align:top"></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Questions and requests for information.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Replies.</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin:3pt 28.8pt 3pt 14.4pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Give full name and address of person to whom children’s pensions, if granted, are to be paid</span><span style="width:25.11pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Name</span></p><p style="margin-top:12pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Address</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">If discharged from the Forces, state the date of your discharge</span><span style="width:15.24pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Have you earned any money since your discharge from the Forces?</span><span style="width:27.72pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">If so, give full particulars</span><span style="width:113.51pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.................</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Are you or your wife or your children receiving or entitled to receive any payment under any Commonwealth Act other than the </span><span style="font-family:'Times New Roman', serif; font-style:italic">Australian Soldiers’ Repatriation Act </span><span style="font-family:'Times New Roman', serif">1920</span><span style="font-family:'Times New Roman', serif; font-variant:small-caps">–</span><span style="font-family:'Times New Roman', serif">1922, or under any Imperial Act or State Act? If so, give full particulars</span><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">At what Post Office should your pension, if granted, be paid?</span><span style="width:17.95pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-top:3pt; margin-left:14.4pt; margin-bottom:3pt; text-indent:-14.4pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">At what Post Office should the pensions of your wife and children, if granted, be paid?</span><span style="width:13.85pt; text-indent:0pt; display:inline-block"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:198.05pt"></td><td style="width:47pt"></td><td style="width:31.3pt"></td><td style="width:105.2pt"></td><td style="width:99.25pt"></td><td style="width:4.85pt"></td></tr></tbody></table>
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<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Approximate number in stock.</span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Number now required.</span></p></td><td style="width:67.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Designation of Form.</span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="20" style="width:67.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">G</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Application for Duplicate War Pension Certificate.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">H</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">War Pension Identification Card.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">J</span><span style="width:25.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">War Pension Certificate.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">K</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">War Pension Medical Certificate.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">L</span><span style="width:23.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">District Register of War Pension Claims.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">M</span><span style="width:20.8pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Declaration of Trustee (combined with War Pension Receipt).</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">N</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Declaration of Spinster or Widow (combined with War Pension Receipt).</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">O</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">War Pension Order, Receipt and Declaration.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">P</span><span style="width:23.79pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">War Pension Receipt.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">R</span><span style="width:22.8pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Report of Registrar.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">S</span><span style="width:23.79pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Confidential Report.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">T</span><span style="width:23.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Police Report.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">U</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Record of Evidence.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">W</span><span style="width:20.31pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Request to Claimant for Attendance.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">X</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Claim on behalf of Dependants under the age of sixteen years.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Y</span><span style="width:22.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Claim by a Dependant (including wife or widow) over the age of sixteen years.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">Z</span><span style="width:23.3pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Claim by an Incapacitated Member of the Forces.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">WW</span><span style="width:11.81pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Death of War Pensioner.</span></p><p style="margin-left:28.8pt; margin-bottom:0pt; text-indent:-28.8pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif">XX</span><span style="width:15.8pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Postage and Telegram Docket Book for Postmasters and Registrars.</span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:9.25pt"><td style="width:16.26%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.1%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
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<table cellspacing="0" cellpadding="0" style="width:100%; margin-bottom:0pt; border-collapse:collapse"><tbody><tr style="height:66.7pt"><td style="width:15.02%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Approximate Number in Stock.</span></p></td><td style="width:16.22%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Number How Required.</span></p></td><td style="width:68.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:middle"><p style="margin-bottom:0pt; text-align:center; line-height:normal"><span style="font-family:'Times New Roman', serif">Designation of Form.</span></p></td></tr><tr style="height:12.65pt"><td style="width:15.02%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.22%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="38" style="width:68.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:1.62pt; vertical-align:top"><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">YY</span><span style="width:20.11pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">War Pension Requisition.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">ZZ</span><span style="width:22.56pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Application for Transfer of War Pension.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z1</span><span style="width:23.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">War Pension Docket Books.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z5</span><span style="width:23.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Examiner’s Report on Claim in Form Y.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z6</span><span style="width:23.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Examiner’s Report on Claim in Form X.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z7</span><span style="width:23.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Grant of War Pension.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z8</span><span style="width:23.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Notice to Trustee of War Pension granted.</span></p><p style="margin-top:3pt; margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z9</span><span style="width:23.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Alteration of Rate of Pension</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z10</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Notice of Alteration (combined).</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z11</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Examiner’s Report on Claim in Form Z.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z12</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Cancellation of Pension, and</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z13</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Notice of Cancellation (combined).</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z14</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Rejection of War Pension Claim.</span></p><p style="margin-top:3pt; margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z15</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Additional War Pension Grant, and</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z16</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Advice to Trustee of Additional Grant (combined).</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">*Z17</span><span style="width:12.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">“C” Index Card—Member’s Card.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">*Z18</span><span style="width:12.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">“C” Index Card—Claimant’s Card (where surname different from that of member).</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">*Z19</span><span style="width:12.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Record of Pensions Granted.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">*Z20</span><span style="width:12.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Record of Claims Rejected.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">*Z21</span><span style="width:12.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Review Register.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z22</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Register of Payments.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z23</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Query Book.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z24</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Register of Underpayments and Overpayments.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z25</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Notice to Soldier to attend Medical Examination.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z26</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Notice to Medical Officer </span><span style="font-family:'Times New Roman', serif; font-style:italic">re </span><span style="font-family:'Times New Roman', serif">Medical Examination on Review.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">*Z27</span><span style="width:12.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Record of Alterations.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z28</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Notice of Suspension to Postmaster.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">*Z29</span><span style="width:12.78pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Record of Deaths.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z30</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Interstate Transfers—Notification of.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z31</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Transfers In—Register of.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z32</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Transfers Out—Register of.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z33</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Weekly Statistical Record.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z34</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Return of Annual Statistics—Tables A, B, and C.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z35</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Annual Statistical Register.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z36</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Notification </span><span style="font-family:'Times New Roman', serif; font-style:italic">re </span><span style="font-family:'Times New Roman', serif">Pension to Local Committee.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z37</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Summary of Special Cases submitted to Commission.</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z38</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Statement and. Declaration of War Pensioner or Trustee (Dependants).</span></p><p style="margin-left:36pt; margin-bottom:0pt; text-indent:-36pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif">Z39</span><span style="width:18.28pt; text-indent:0pt; display:inline-block"> </span><span style="font-family:'Times New Roman', serif">Statement and Declaration of War Pensioner or Trustee (Ex-soldiers).</span></p></td></tr><tr style="height:1pt"><td style="width:15.02%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.22%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:15.02%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.22%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:15.02%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.22%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:15.02%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.22%; border:0.75pt solid #000000; padding-right:1.62pt; padding-left:1.62pt; vertical-align:top"><p style="margin-bottom:0pt; text-align:justify; line-height:normal"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:15.02%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:1.62pt; padding-left:2pt; vertical-align:top"><p style="margin-bottom:0pt; 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Establishment of institutions.
The Commission may maintain, erect, equip, and conduct such homes, hostels, hospitals, sanatoria, workshops, and training establishments for the benefit of soldiers or their dependants.
Grants by Commission.
The Commission may grant assistance and benefits including the payment of any allowances or sum of money purporting to be a pension under Part III. of the Act to any person who is included in any of the classes of persons specified in section 60 of the Act, but in respect of whom provision is not made in these Regulations for the granting of assistance and benefits applied for.
Power of Commission to confirm irregular grants
179a. (1) Where a Deputy Commissioner or a Board or the Executive of a Country Local Committee has made either before or after the commencement of this regulation, a grant of benefits or assistance which is not authorized by these Regulations but which the Commission has power to grant under these Regulations, the Commission may, in its absolute discretion, authorize and confirm the grant so made, and the grant shall thereupon be deemed to have been made in pursuance of these Regulations.
(2) Nothing in the last preceding sub-regulation shall be construed as conferring any additional power on a Deputy Commissioner or a Board or the Executive of a Country Local Committee.
(3) Where, before the commencement of this regulation the Commission has purported to approve of any grant by a Deputy Commissioner, or a Board or the Executive of a Country Local Committee of assistance or benefits which was not authorized by these Regulations the Commission shall be deemed to have authorized and confirmed the grant under this regulation.
Power of Commission to confirm grants purported to be made under Australian Soldiers’ Repatriation Act 1917–1918.
179b. (1) Where a Deputy Comptroller or a State Board or the Executive of a Country Local Committee appointed under the Australian Soldiers’ Repatriation Act 1917–1918 has made a grant of benefits or assistance which was not authorized by the regulations made under that Act but which the Minister had power to grant under those Regulations, the Commission may, in its absolute discretion, authorize and confirm the grant so made and the grant shall thereupon be deemed to have been made in pursuance of those Regulations.
(2) Where, before the commencement of this regulation, the Commission has purported to approve of any grant by a Deputy Comptroller, or a State Board or the Executive of a Country Local Committee of assistance or benefits which was not authorized by those Regulations, the Commission shall be deemed to have authorized and confirmed the grant under this regulation.
Care and education of children.
180. The Commission may, on the recommendation of a Deputy Commissioner, make such arrangements and pay such amounts as it deems necessary for the care and education of the orphan of a deceased soldier or the child of an incapacitated soldier,
Allowance for training of children over 16 and under 18 years of age.
181. (1) A Deputy Commissioner may, subject to the directions of the Commission, grant to the child over sixteen and under eighteen years of age of a deceased or totally and permanently incapacitated soldier, for the purpose of assisting the child to receive secondary education, or to be trained for a trade, calling, or occupation which the Deputy Commissioner deems suitable, such allowance as will insure to the child an income, inclusive of the pension and earnings of the child, of twenty shillings per week.
(2) No bursary or scholarship awarded to any such child shall be taken into account in estimating the amount of the allowance payable to a child under this regulation.
(3) The Deputy-Commissioner may, at any time, if he is satisfied that the child is not receiving education or being trained for the trade, calling, or occupation, revoke the grant of the allowance.
Special allowance to trainees for work
181a. The Commission may authorize the payment of special allowances to soldiers for work performed by them in any medical institution or place approved by the Commission whilst undergoing training and treatment therein.
Hire-purchase.
The Commission may, under an agreement in accordance with Form D in the Schedule, supply to a soldier or his widow, furniture, tools of trade, or other chattels available for the purpose.
Delegation of powers by Commission.
(1) The Commission may, by writing under its hand and seal, delegate any of its powers under these Regulations (except this power of delegation) in relation to any matters or class of matters or to any particular State or
Territory so that the delegated powers may be exercised by the delegate with respect to the matters specified, or the State or Territory defined in the instrument of delegation.
(2) Every delegation by the Commission shall be revocable in writing at will, and no delegation shall prevent the exercise of any power by the Commission.
(3) Any such delegation by the Commission shall be deemed to operate from the date specified in the said delegation.
Procedure where Board reduced to less than quorum.
Should the number of members of a Board be reduced to less than the quorum fixed by the Act, the Commission may, by writing under its hand, authorize a Deputy Commissioner or such other person as the Commission thinks fit, to exercise during the pleasure of the Commission like powers to those exercisable by the Board under these Regulations.
Evidence taken by Board on oath.
A Board shall have power to summon witnesses, take evidence on oath, and require the production of documents in connexion with any matter arising under the Act or these Regulations, or to authorize in writing any person or persons to summon witnesses, take evidence on oath, and require the production of documents on its behalf.
Evidence taken by Soldiers’ State Industrial Committee on oath.
A Soldiers’ State Industrial Committee shall, in relation to any matter referred to it under regulation 74, have power to summon witnesses, take evidence on oath, and require the production of documents.
Witnesses to obey summons.
No person who has been summoned to appear as a witness before a Board or before any person authorized by a Board under regulation 186, or before a Soldiers’ State Industrial Committee, shall, without lawful excuse, and after tender of reasonable expenses, fail to appear in answer to the summons.
Refusal of witness to give evidence.
No person who appears, as required by regulation 186 or regulation 187, shall, without lawful excuse, refuse to be sworn or make affirmation or produce documents or answer questions which he is lawfully required to answer.
Grants to necessitous persons.
A Deputy Commissioner may grant by way of loan or gift an amount not exceeding the sum of £5 to any person who is entitled to benefits under the Act or Regulations, if—
(a) such person is in necessitous circumstances and requires immediate relief; and
(b) the Deputy Commissioner has satisfied himself that, taking into consideration all the circumstances of the case, the grant should be made.
Grants for funeral expenses.
(1.) A Deputy Commissioner or the Executive of a Country Local Committee may grant a sum not exceeding £10 towards the funeral expenses of a discharged soldier—
(a) who dies in indigent circumstances; or
(b) who dies whilst the inmate of a Departmental Hostel or other institution under the control of the Department or while he is a patient in any institution or hospital to which he has been sent under arrangement with the Department or in which the cost of his treatment and maintenance while therein is paid by the Department.
(2) A Deputy Commissioner may grant a sum not exceeding £10 towards the funeral expenses of the widow or orphan (who dies in indigent circumstances) of a soldier whose death has resulted from war service.
Powers of Commission.
Any power or authority vested in a Deputy Commissioner by these Regulations shall be exercisable by the Commission.
Improper use of gifts or loans.
(1) Any person to whom a gift or loan of money or goods has been made or granted under the Act or these Regulations or by a State War Council under the powers conferred by the Australian Soldiers’ Repatriation Fund Regulations 1916, for any purpose, and who, without first obtaining the consent of a Board—
(a) uses the money or goods for any other purpose; or
(b) sells or otherwise disposes of, or in any way pledges, mortgages, or deposits, by way of security, any goods so granted or any goods purchased with any money so given or lent,
(2) Any person who does any of the things mentioned in the last preceding sub-regulation shall, in addition to the liability under that sub-regulation, be ineligible to receive any further assistance and benefits under the Act or these Regulations:
Provided that no such person shall be ineligible to receive medical benefits under these Regulations by reason only of the fact that he has so used or dealt with the money or goods.
Penalty for non-disclosure of prior charge.
Any person who, as security for an advance under the Act or these Regulations—
(a) mortgages any land or chattel which is subject to a charge or encumbrance; or
(b) mortgages any chattel of which he is not the owner,
without disclosing to the Commission the existence of that charge or encumbrance, or that he is not the owner of the chattel, shall be guilty of an offence.
Penalty for false statement.
(1) Any person who, by word of mouth or in writing, makes a false statement in, or in connexion with, or in support of, any application for assistance or benefits under the Act or Regulations shall be guilty of an offence.
(2) Any person convicted under this regulation may, in addition to the penalty imposed for the offence, be ordered to repay or return to the Commission any money, allowances, or goods received by him pursuant to the application.
(3) In any proceedings for an offence against this regulation the burden of proving that the statement in respect of which the proceedings have been instituted is true shall rest on the person accused.
Burden of proof of lawful consent or excuse on accused.
195a. Where under these Regulations any act if done without lawful consent or without lawful excuse is an offence against these Regulations, the burden of proving that the act was done with lawful consent shall rest on the person accused.
Penalties.
196. In these Regulations the penalty set out at the foot of any regulation or sub-regulation indicates that any person who commits—
(a) the offence created by that regulation or sub-regulation; or
(b) a breach of that regulation or sub-regulation, whether by act or omission,
shall be punishable upon conviction by a penalty not exceeding the penalty set out.
Time for commencement of prosecutions.
196a. A prosecution in respect of an offence against these Regulations may be commenced at any time within three years after the commission of the offence.
Repeal.
196b. The Australian Soldiers’ Repatriation Regulations 1920 (being Statutory Rules 1920, No. 112 as amended by Statutory Rules 1920, Nos. 125, 151, 243 and 247; 1921, Nos. 31, 50, 188, 189, 192 and 201; 1922, Nos. 19, 25, 27, 37, 50, 55, 105, 107, 108 and 155; 1923, Nos. 29, 82, 156 and 204; 1924, Nos. 97, 149 and 158; and 1925, Nos. 24, 76, and 91) are hereby repealed.
Saving of assistance and benefits, rights, powers, &c., under Australian Soldiers’ Repatriation Act 1917–1918 and regulations thereunder.
197. (1) Notwithstanding the repeal of the regulations set out in the last preceding regulation, anything lawfully done, and any assistance or benefits granted, under those regulations which could have been done or granted under these Regulations, if these Regulations had been in force at the time when the thing was done or the assistance or benefits were granted, shall be deemed to have been done or granted under these Regulations.
(2) Notwithstanding the repeal of the regulations set out in the last preceding regulation, entries in the Register of Securities established under those regulations shall be deemed to be of the same force and effect as if they were entries in the Register of Securities established under these Regulations, and any person may search that Register and take extracts therefrom as if it were the Register established under these Regulations.
(3) Notwithstanding the repeal of the Australian Soldiers’ Repatriation Act 1917–1918 and the expiration of the regulations made thereunder, and of the repeal of the regulations set out in the last preceding regulation, the Commission may exercise all the powers and functions of the Minister under that Act and those regulations, in respect of any security given under that Act or those regulations, and in respect of any property, real or personal, referred to in the security to the same extent as if that Act and those regulations were still in force, and the name of the Commission were substituted therein for that of the Minister.
THE SCHEDULE.
Form A
——
PERSONAL SECURITY PURSUANT TO THE REGULATIONS UNDER THE AUSTRALIAN SOLDIERS’ REPATRIATION ACT 1920–1922.
1. The Borrower’s full name is
2. The Borrower’s full address is
3. The Borrower’s occupation is
4. The amount lent is (£ )
*5. Interest at the rate of five pounds per centum per annum is payable on the amount of the loan in excess of the sum of fifty pounds for the time being remaining unpaid.
*6. The loan is to be fully repaid with interest on or before the day of 192
*7. The loan is repayable by instalments of £ each on the day of each month until the principal sum is fully repaid—the first instalment being due on the day of 192 . Interest is payable on the amount of the loan in excess of the sum of fifty pounds for the time being remaining unpaid on the day of each month.
8. All payments and repayments hereunder are to be made at the office of the Deputy Commissioner of Repatriation for the State of
I, the above-named Borrower, hereby promise to repay to the Repatriation Commission the full amount lent,* and each instalment thereof,* and to pay all interest payable thereon at the times and at the place and in the manner above stated. And I undertake to comply with all the obligations imposed upon me by this Security and by the Regulations.
Dated this day of 192
Borrower,
Image unavailable in extracted textSigned by the Borrower at
in
The Schedule
————
Form B.
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MORTGAGE OF CHATTELS PURSUANT TO THE REGULATIONS UNDER THE AUSTRALIAN SOLDIERS’ REPATRIATION ACT 1920–1922.
1. The Mortgagor’s full name is
2. The Mortgagor’s full address is
3. The Mortgagor’s occupation is
4. The chattels hereby mortgaged are specified in the Schedule hereto.
5. The mortgaged chattels are situated at
6. The amount lent is (£ ).
*7. Interest at the rate of five pounds per centum per annum is payable on the amount of the loan in excess of the sum of fifty pounds for the time being remaining unpaid.
* Note.—If interest is not payable, or if repayment is not to be made by instalments, particulars 5, 6 and 7 of Form A. and 7, 8, and 9 of Form B should be amended accordingly.
*8. The loan is to be fully repaid with interest on or before the day of , 192
*9. The loan is repayable by instalments of £ each on the day of each month until the principal sum is fully repaid—the first instalment being due on the day of 192 . Interest is payable on the amount of loan in excess of the sum of fifty pounds for the time being remaining unpaid on the day of each month.
10. The Mortgagor shall, in the joint names of the Commission and of the Mortgagor, insure the chattels against fire for the full amount lent.
11. All payments and repayments hereunder are to be made at the office of the Deputy Commissioner of Repatriation for the State of
I, the above-named Mortgagor, hereby mortgage to the Repatriation Commission the chattels above mentioned as security for the amount lent, and I promise to repay the full amount lent,* and each instalment thereof,* and to pay all interest payable thereon at the times and at the place and in the manner above stated. And I undertake to comply with all the obligations imposed upon me by this Mortgage and by the Regulations.
Dated this day of , 192
Mortgagor.
Image unavailable in extracted textSigned by the Mortgagor at
in
The Schedule.
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Form C.
——
MORTGAGE OF LAND PURSUANT TO THE REGULATIONS UNDER THE AUSTRALIAN SOLDIERS’ REPATRIATION ACT 1920–1922.
1. The Mortgagor’s full name is
2. The Mortgagor’s full address is
3. The Mortgagor’s occupation is
4. The land hereby mortgaged is as follows:—
5. The amount lent is (£ ).
*6. Interest at the rate of five pounds per centum per annum is payable on the amount of the loan for the time being remaining unpaid.
*7. The loan is to be fully repaid with interest on or before the day of , 192 .
*8. The loan is repayable by instalments of £ each on the day of each month until the principal sum is fully repaid—the first instalment being due on the day of 192 . Interest computed from the day of 192 is payable on the amount of the loan in excess of the sum of fifty pounds for the time being remaining unpaid on the day of each month. The first instalment of interest being due on the day of 192 .
9. The Mortgagor shall, in the joint names of the Commission and of the Mortgagor, insure all buildings on the mortgaged land against fire for their full insurable value.
10. All payments and repayments hereunder are to be made at the office of the Deputy Commissioner of Repatriation for the State of
I, the above-named Mortgagor, hereby mortgage to the Repatriation Commission the land above mentioned as security for the amount lent. And I promise to repay the full amount lent,* and each instalment thereof,* and to pay all interest payable thereon at the times and at the place and in the manner above stated. And I undertake to comply with all the obligations imposed upon me by this Mortgage and by the Regulations.
Dated this day of , 192 .
Mortgagor.
Image unavailable in extracted textSigned by the Mortgagor at
in
* Note.—If interest is not payable, or if repayment is not to be made by instalments, particulars 7, 8, and 9 of Form B, and 6, 7, and 8 of Form C should be amended accordingly.
Form D.
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HIRE PURCHASE AGREEMENT PURSUANT TO THE REGULATIONS UNDER THE AUSTRALIAN SOLDIERS’ REPATRIATION ACT 1920–1922.
1. The Hirer’s full name is
2. The Hirer’s full address is
3. The Hirer’s occupation is
4. The chattels here by hired are specified in the Schedule hereto.
5. The chattels are situated at
6. Hire is payable at the rate of on the day of each month during the hiring—the first payment being due on the day of , 192 .
7. The value of the chattels is £ , and when that amount has been paid as hire the chattels shall be the property of the Hirer absolutely.
8. (a) The hirer shall pay to the Commission an insurance premium of 1s., due on the day of in each year, during which this agreement is in force.
(b) If damage or loss by fire is caused to any of the chattels, the Hirer shall forthwith furnish the Deputy Commissioner of Repatriation for the State of with full particulars thereof in writing, and all information in his possession in regard thereto and the cause thereof.
9. All payments hereunder are to be made at the office of the Deputy Commissioner of Repatriation for the State of
10. If any obligation imposed upon the Hirer by this Agreement or by the Regulations is not complied with, the Hirer shall forthwith return the chattels to the Commission.
I, the above-named Hirer, hereby agree to pay to the Repatriation Commission at the times and at the place and in the manner above stated the full amount of hire payable under this Security. And I undertake to comply with all the obligations imposed upon me by this Agreement and by the Regulations.
Dated this day of 192 .
Hirer.
Image unavailable in extracted textSigned by the Hirer at
in
The Schedule.
————
Form E.
——
REGISTER OF SECURITIES.
Form G.
————
————
APPLICATION FOR DUPLICATE CERTIFICATE.
To the Deputy Commissioner of Repatriation at
I, of being a *pensioner /*trustee under the aforesaid Act, hereby make application for a duplicate Pension Certificate in lieu of the original Certificate No. , payment in accordance with which is made at ; and in support of the application I hereby declare as follows:—
1. The name or names of the pensioner or pensioners is or are
2. The original Certificate was duly issued to me and has been *lost./*destroyed.
3.†
4. *I have made diligent search for the lost Certificate, but have been unable to find it.
5. I do hereby solemnly declare that this statement is true.
Declared by the said at this day of , 192 , before me—‡ §
Applicant.
† If destroyed, state when and how.
‡ The person before whom this declaration is made to sign here and add the title by which he takes the declaration, such as “Postmaster”, &c.
§ The declaration may be made before any of the following persons:—A postmaster or postmistress or person in charge of a post-office, a police, stipendiary or special magistrate of the Commonwealth or of a State, a justice of the peace, a barrister or solicitor, a State school head teacher, an officer of the Department of Trade and Customs, a member of the police force of the Commonwealth or of a State, a legally qualified medical practitioner, a notary public, a commissioner for affidavits, a registrar under the Invalid and Old-age Pensions Act 1908–1923, a minister of religion, an officer of the Repatriation Department, a member of the Parliament of the Commonwealth or a commissioned officer of the Australian Military Forces.
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——
Form H.
——
Image unavailable in extracted textName of member of Forces in respect of whose
death or incapacity this Pension is payable
Number Rank Unit
WAR PENSION IDENTIFICATION CARD.
[The Postmaster, or other Official, must retain this card, as his authority for paying pension. This card should not be folded.]
The instalments are payable to as *Pensioner./* Trustee. Number.
Pension at the rate of fortnightly has been granted from payable in advance at
Deputy Commissioner.
* Strike out which is inapplicable.
[Outside of Card.]
| --- | --- | --- | --- |
Form j.
WAR PENSION CERTIFICATE.
I certify that a Pension, as detailed on the other side hereof, has been granted. The first instalment payable was due on Pension Thursday, the 192 on which date the following amount became due:—
Odd days, from to £
Fortnight in advance, from
Total.............................£
Deputy Commissioner.
Date
The Pension is payable only at the office named herein, and no application for Temporary Transfer to another office will be entertained.
This Certificate must be produced when application is made for payment of each instalment of Pension, and no instalment will be paid without its production.
If the pensioner or the trustee cannot apply in person, he may, on a form obtainable from any Post Office, give an order to another person.
It is important to note that a Pension is not a security on which money may be borrowed, because, subject to the Act, a pension is absolutely inalienable whether by way or in consequence of sale, assignment, charge, execution, insolvency, or otherwise howsoever.
Transfers to another office of payment should be noted hereunder:—
Payment to be made in future at—
Signature of Postmaster.
Date.
[Inside of Card.]
Pension Certificate Number
Total fortnightly Rate pounds shillings pence, payable at
Image unavailable in extracted text* Pensioner’s/* Trustee’s Signature
(or witnessed mark)
Image unavailable in extracted textWitness to
mark
| --- | --- | --- | --- | --- | --- | --- | --- |
The officer paying to place his date stamp on the proper space when payment is made. If he has no date stamp, he must place his initials and the date in the space (in ink, not pencil).
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Form K.
——
WAR PENSION MEDICAL REPORT.
*I /*We have this day examined the above-named person for War Pension purposes in respect of the above-mentioned disability or disabilities, and the following report is submitted:—
1. States he is suffering from.............
2. Age............................
Weight st. lb. (Coat and vest off)
3. Describe in detail the present condition of the disability or disabilities recorded under (a), (b), or (c) above. (Heart and lungs must be examined in all cases).
(a)
4. The above condition is the result of.......
5. In my opinion the improvement during the past six months has been
6. State any other disabilities not recorded in 3 above, indicating whether
(a) Due to war service.(b) Due to post-war causes
7. Period of incapacity.................(Indicate if condition permanent)
The condition is such as to render him *totally /*partially incapacitated for a period of months from this date.
Form K—continued.
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Form L.
——
——
THE DISTRICT REGISTER OF WAR PENSION CLAIMS.
Date of Receipt of Claim.
Name of Claimant.
Address of Claimant
Surname of each Person for whom Pension Claimed.
Christian Name of each Person for whom Pension Claimed.
Date when papers forwarded to the Deputy Commissioner.
Remarks.
Form M.
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——
——
DECLARATION OF TRUSTEE.
I hereby declare that the pensioners whose names are written below are alive at the date which is written after my signature hereon and that I am entitled to draw their pensions.
Names of pensioners—
Date
Note.—This form will not be accepted by the postmaster if it bears a date prior to the date on which the instalment became due.
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Form N.
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——
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DECLARATION OF SPINSTER OR WIDOW.
I, , hereby declare that I am a female dependant of who was my and that, since the date of the grant of pension to me, I have not married or re-married.
(Here write full name of Member of the Forces.) (Here state relationship.)
Date
———
Post Office Date Stamp to
Image unavailable in extracted text
Form O.
———
———
The Australian Soldiers’ Repatriation Act 1920–1922. be placed in this square.
———
WAR PENSION ORDER, RECEIPT AND DECLARATION.
I, , hereby authorize (Name in Full) who is over sixteen years (Name in Full)
of age, to receive the pension payable under the Certificate above referred to for the fortnight commenced
Signature of Pensioner or Trustee
Postal Address Date
£
s.
d.
Receipt and Declaration.
I,
(Name in full)
being over sixteen years of age, acknowledge to have received the sum of being pension payable as above. I have reason to believe that the person whose signature appears above is still alive. I hereby declare that I am not receiving the pension instalment on my own behalf or on behalf of any other person, firm, business, or company, in repayment of any advance or loan to the pensioner, or in payment of any interest or charge in connexion with any such advance or loan, or by way of it, or in consequence of, any sale, assignment, charge, execution, or insolvency.
Note.—Whenever payment of a pension instalment is made, the paying officer will hand to the person who is paid a blank form of receipt, which must be brought back on the next pension pay day, already filled in and signed.
SignatureAddressDate
Form P.
——— Post Office Date Stamp to be
Image unavailable in extracted text
———
The Australian Soldiers’ Repatriation Act 1920–1922. placed in this square.
———
WAR PENSION RECEIPT.
£
s.
d.
I acknowledge to have received the sum of being Pension payable in advance in accordance with Pension Certificate numbered as above for the fortnight commenced
Date
Note.—Whenever payment of a pension instalment is made, the paying officer will hand to the pensioner or the trustee a blank form of receipt, which must be brought back, on the next pension pay-day, already filled in and signed, If the pensioner or the trustee cannot call at the pay-office, he should not use this form of receipt, but he may obtain from any Post Office an order form, on which he may authorize another person to draw an instalment of the pension.
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Form R.
——
——
——
REPORT OF REGISTRAR.
——
To the Deputy Commissioner of Repatriation at
[Here set out the name and the relationship to the member of the Forces of each person for whom pension is claimed.]
[Here set out names of dependants and extent of dependence in each case, except where the claim is made by or on behalf of—
(i) the wife or widow of a member of the Forces;
(ii) the children (under sixteen years of age) of a member;
(iii) the widowed mother of a deceased unmarried member;
(iv) the parents of a member who are claiming pension on the ground of being without adequate means of support.]
I have to report that I have investigated the claim made by for a pension for and I find that
I also find that
I further find that the person whose name and address here follow is a person over the age of sixteen years who is able and willing to receive and economically disburse the pensions which may be granted in pursuance of the claim under notice.
The name and address referred to are:—
Registrar of Pensions at
Date
Form S.
———
———
———
CONFIDENTIAL REPORT.
———
Regulation 18 of the Regulations made under the Act reads as follows:—
“18. The Commission or the Deputy Commissioner or the Registrar may require any person whom he believes to be in a position to do so, to furnish to him a confidential written report as to—
(a) the circumstances,
(b) the names, ages and means of livelihood of the dependants,
(c) the family and blood relations,
(d) the means of livelihood, and
(e) the age,
of any person who claims a pension or for whom a pension is claimed; and any persons who, on being required to do so by the Commission or the Deputy Commissioner or the Registrar, fails to furnish such a report within a reasonable time, or furnishes a report containing any statement which is untrue in any particular, shall be guilty of an offence against these Regulations.
Penalty: Twenty-five pounds.”
From the Registrar of Pensions at
To
Claimant—Name
It is requested that you will be good enough to supply, on this form, the information which is asked for hereunder.
Registrar of Pensions
Date
Information asked for—
Reply—
Date
———
Form T.
———
———
———
POLICE REPORT.
———
From the Registrar of Pensions at
To the Officer in Charge of Police at
Claimant—Name
It is requested you will be good enough to make inquiries and report to me in the matter referred to hereunder. The inquiries should be made, if possible, from disinterested persons.
The report may be returned to me without prepayment of postage, if enclosed in the official envelope of any Commonwealth or State Department and indorsed “War Pensions”.
Registrar of Pensions.
Date
Matter in which report is requested
Report
(Name and rank of member of Police Force who makes the report.)
Date
Form U.
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———
———
RECORD OF EVIDENCE.
———
Evidence given by of
in respect of the claim made by
for a pension to be paid to
Date
The foregoing evidence was read by me to the person who gave it before he (or she) signed this sheet.
*Registrar of Pensions at
*Special Magistrate at
Date
———
Form W.
———
———
———
REQUEST TO CLAIMANT FOR ATTENDANCE.
———
To
You are requested to attend at my office
at o’clock in the noon of 192 , in order that you may give evidence in relation to the claim made by you for a war pension. It is further requested that you bring with you some other person over the age of sixteen years who has a knowledge of the circumstances of the person or persons for whom pension is claimed.
If you are unable to attend, you should so inform me immediately, and give the reason which prevents your attendance.
* Registrar of Pensions.
* Special Magistrate.
Date
———
Form X.
———
———
———
(This Form is to be used only in claiming Pensions for Dependants under the age of sixteen years. Before filling up the form, read the particulars given on the back of the form for the information of Registrars, Special Magistrates, and Claimants.)
Section 44 of the Australian Soldiers’ Repatriation Act 1920–1922 reads as follows:—
(a) makes, either orally or in writing, a false or misleading statement in, or is connexion with, or in support of, any application for pension;
(c) obtains payment of any pension or instalment of pension by means of any false or misleading statement; or
(d) makes or presents to the Minister or the Commission or to any officer doing duty in relation to this Act or the Regulations, any statement or document which is false in any particular,
“(2.) Any person convicted of an offence against this section may, in addition to the penalty imposed for the offence, be ordered to repay to the Commission any amount received by him by way of pension in consequence of the act in respect of which he was convicted.
“(3.) In any proceedings for an offence against this section the burden of proving the truth of the statement in respect of which the proceedings have been instituted, or the genuineness of the document presented, shall rest on the person accused.
“(4.) Proceedings under this section may be taken before a Court of summary jurisdiction, and may be commenced at any time within three years after the commission of the offence.”
———
I, [here write full name] residing at [here write full postal address and occupation] hereby claim a pension for each Dependant who is named in this Pension Claim. I declare that I am more than sixteen years of age and that, to the best of my knowledge and belief, the following replies to the questions and requests for Information are true and correct in every particular.
Questions and requests for information.
Replies.
Give the full name of the member of the Forces on whose death or incapacity the claim is based
State his rank, his number (if known), and the regiment or branch of the Forces in which he served
No. RankRegiment, &c.
State whether he is dead, or is alive but incapacitated
State in respect of his first marriage:—Full maiden name of wife.............Date of marriage...................Place of marriage..................
State in respect of his second marriage (if any):—Full maiden name of wife.............Date of marriage...................Place of marriage..................
Give similar details in relation to his other marriages (if any)
Questions and requests for information.
Replies.
State in respect of the first dependant for whom pension is claimed:—Full name of dependant...............Date of birth of dependant..............Place of birth of dependant.............Where living at present................Full name of father of dependant.........Full maiden name of mother of dependant...Relationship of dependant to the deceased or incapacitated member of Forces who is named above*
State in respect of the second dependant for whom pension is claimed:—Full name of dependant...............Date of birth of dependant..............Place of birth of dependant.............Where living at present................Full name of father of dependant.........Full maiden name of mother of dependant...Relationship of dependant to the deceased or incapacitated member of Forces who is named above*
State in respect of the third dependant for whom pension is claimed:—Full name of dependant...............Date of birth of dependant..............Place of birth of dependant.............Where living at present................Full name of father of dependant.........Full maiden name of mother of dependant...Relationship of dependant to the deceased or incapacitated member of Forces who is named above*
State in respect of the fourth dependant for whom pension is claimed:—Full name of dependant...............Date of birth of dependant..............Place of birth of dependant.............Where living at present................Full name of father of dependant.........Full maiden name of mother of dependant...Relationship of dependant to the deceased or incapacitated member of Forces who is named above*
* State here whether the relationship is that of son, daughter, grandson, granddaughter, step-son step-daughter, brother, sister, half-brother, half-sister, adopted child, ex-nuptial child or ex-nuptial grandchild.
Questions and requests for information.
Replies.
State in respect of the fifth dependant for whom pension is claimed:—Full name of dependant...............Date of birth of dependant..............Place of birth of dependant.............Where living at present................Full name of father of dependant.........Full maiden name of mother of dependant...Relationship of dependant to the deceased or incapacitated member of Forces who is named above*
State in respect of the sixth dependant for whom pension is claimed:—Full name of dependant...............Date of birth of dependant..............Place of birth of dependant.............Where living at present................Full name of father of dependant.........Full maiden name of mother of dependant...Relationship of dependant to the deceased or incapacitated member of Forces who is named above*
Give similar details in respect of each other dependant for whom pension is claimed
If any of the persons named in this claim is a child of the aforesaid member of the Forces, state whether its mother is dead, and give the date and place of her death
Was every one of the persons named in this claim dependent upon the earnings of the aforesaid member of the Forces during the period of twelve months prior to his enlistment or appointment?
Do you consider yourself well qualified to speak of the sources of maintenance of the dependants referred to in this claim?
Give your reasons for considering yourself to be so qualified
What is your relationship to the dependants?......
In the twelve months prior to the enlistment or appointment of the aforesaid member of the Forces did any other person maintain or contribute towards the maintenance of any of the dependants referred to in this claim?
*State here whether the relationship is that of son, daughter, grandson, granddaughter, step-son, step-daughter, brother, sister, half-brother, half-sister, adopted child, ex-nuptial child or ex-nuptial grandchild.
Questions and requests for information.
Replies.
If so, give full particulars...................
Did any of the dependants referred to in this claim earn money in the said period of twelve months?
If so, give full particulars...................
Give the name and address of some person over the age of sixteen years who is able and willing to receive and economically disburse the pensions which may be granted in pursuance of this claim*
What relationship does such person bear to the dependants?
Are any of the dependants named in this claim receiving or are they entitled to receive any payment under any Commonwealth Act other than the Australian Soldiers’ Repatriation Act 1920–1922, or under any Imperial Act or State Act?
If so, give full particulars...................
At what Post Office should pensions, if granted, be paid?
Give the names and addresses of all persons known to you (other than those named in this claim) who were dependent upon the earnings of the aforesaid member of the Forces within the twelve months prior to his enlistment or appointment
Give the names and addresses of all persons known to you who are already receiving pensions in respect of the death or incapacity of the aforesaid member of the Forces
* If the dependants have a parent, the parent’s name and address should be here given unless the parent is a person to whom, for any reason, the pension should not be paid.
Declared at the day of 192
*†
* The person before whom this declaration is made to sign here and add the title by which he takes the declaration, such as “Postmaster”, &c.
† The declaration may be made before any of the following persons:—A postmaster or postmistress, or person in charge of a post office, a police, stipendiary, or special magistrate of the Commonwealth or of a State, a justice of the peace, a barrister or solicitor, a State school head-teacher, an officer of the Department of Trade and Customs, a member of the police force of the Commonwealth or of a State, a legally qualified medical practitioner, a notary public, a commissioner for affidavits, a registrar under the Invalid and Old-age Pensions Act 1908–1923, a minister of religion, an officer of the Repatriation Department, a member of the Parliament of the Commonwealth, or a commissioned officer of the Australian Military Forces.
The foregoing claim was received by me on 192
Form Y.
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Claim by a Dependant (including Wife or Widow) Over the Age of Sixteen Years.
(Before filling up this form, read the particulars given on the back of the form for the information of Registrars, Special Magistrates, and Claimants.)
Section 44 of the Australian Soldiers’ Repatriation Act 1920–1922 reads as follows:—
(a) makes, either orally or in writing, a false or misleading statement in, or in connexion with, or in support of, any application for pension;
(c) obtains payment of any pension or instalment of pension by means of any false or misleading statement; or
(d) makes or presents to the Minister or the Commission or to any officer doing duty in relation to this Act or the Regulations, any statement or document which is false in any particular,
“(2.) Any person convicted of an offence against this section may, in addition to the penalty imposed for the offence, be ordered to repay to the Commission any amount received by him by way of pension in consequence of the act in respect of which he was convicted.
“(3.) In any proceedings for an offence against this section the burden of proving the truth of the statement in respect of which the proceedings have been instituted, or the genuineness of the document presented, shall rest on the person accused.
“(4.) Proceedings under this section may be taken before a Court of summary jurisdiction, and may be commenced at any time within three years after the commission of the offence.”
———
I, [here write full name] of [here write full postal address] hereby claim for myself a pension, and I declare that, to the best of my knowledge and belief, the following replies to the questions and requests for information are true and correct in every particular.
Questions and requests for information.
Replies.
Give the full name of the member of the Forces on whose death or incapacity the claim is based
State his rank, his number (if known), and the regiment or branch of the Forces in which he served
No. RankRegiment, &c.
Where was he born? (Give name of town and country, if known.)
When was he born? (Give exact date, if known)
Was he single, married, or a widower? (State which)
State whether he is dead, or is alive but incapacitated
What is your relationship to him?..........
Questions and requests for information.
Replies.
Where were you born? (Give name of town and country, if known)
When were you born? (Give exact date, if known).
What is your occupation?..................
Are you single, married, widow, or widower? (State which)
If you are a widow, state the date and place of your husband’s death
If you are or have been married, state, in respect of your first marriage:—Full name of husband................Full maiden name of wife.............Place of marriage...................Date of marriage...................
Give similar particulars of your other marriage or marriages (if any)
Were you dependent upon the earnings of the aforesaid member of the Forces at any time during the period of twelve months prior to his enlistment or appointment?
If you were dependent, give full particulars
In the twelve months prior to the enlistment or appointment of the aforesaid member of the Forces did any other person contribute towards your maintenance?
If so, give full particulars..................
Did you earn any money in the said period of twelve months?
If so, give full particulars..................
Did you, during the said period of twelve months, have any means of support other than means of support shown on this page?
Questions and requests for information.
Replies.
If so, give full particulars.................
Are you in receipt of an Invalid or Old-age Pension?
Have you at any time applied for an Invalid or Old-age pension?
If so, state when and where...............
Are you receiving or entitled to receive, any payment under any Commonwealth Act other than the Australian Soldiers Repatriation Act 1920–1922 or under any Imperial Act or State Act?
If so, give full particulars.................
At what Post Office should pension, if granted, be paid?
Give the names and addresses of all persons known to you who were dependent upon the earnings of the aforesaid member of the Forces at any time within the twelve months prior to his enlistment or appointment
Give the names and addresses of all persons known to you who are already receiving pensions in respect of the death or in capacity of the aforesaid member of the Forces
Declared at the day of 192 .
*†
* The person before whom this declaration is made to sign here and add the title by which he takes the declaration, such as “Postmaster”, &c.
† The declaration may be made before any of the following persons:—A postmaster or postmistress, or person in charge of a post office, a police, stipendiary, or special magistrate of the Commonwealth or of a State, a justice of the peace, a barrister or solicitor, a State school head-teacher, an officer of the Department of Trade and Customs, a member of the police force of the Commonwealth or of a State, a legally qualified medical practitioner, a notary public, a commissioner for affidavits, a registrar under the Invalid and Old-age Pensions Act 1908–1923, a minister of religion, an officer of the Repatriation Department, a member of the Parliament of the Commonwealth, or a commissioned officer of the Australian Military Forces.
The foregoing claim was received by me on 192 .
Form Z.
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———
———
Claim by an Incapacitated Member of the Forces.
Before filling up this form, read the particulars given on the back of the form for the information of Registrars, Special Magistrates, and Claimants.)
Section 44 of the Australian Soldiers’ Repatriation Act 1920–1922 reads:—
(a) makes, either orally or in writing, a false or misleading statement in, or in connexion with, or in support of, any application for pension;
(e) obtains payment of any pension or instalment of pension by means of any false or misleading statement; or
(d) makes or presents to the Minister or the Commission or to any officer doing duty in relation to this Act or the Regulations, any statement or document which is false in any particular,
“(2.) Any person convicted of an offence against this section may, in addition to the penalty imposed for the offence, be ordered to repay to the Commission any amount received by him by way of pension in consequence of the act in respect of which he was convicted.
“(3.) In any proceedings for an offence against this section the burden of proving the truth of the statement in respect of which the proceedings have been instituted or the genuineness of the document presented, shall rest on the person accused.
“(4.) Proceedings under this section may be taken before a Court of summary jurisdiction, and may be commenced at any time within three years after the commission of the offence.”
———
I, [here write full name] of [here write full postal address]
hereby claim pensions for myself, my wife, and my children, and I declare that, to the best of my knowledge and belief, the following replies to the questions and requests for information are true and correct in every particular.
If you have any living children under the age of sixteen years, give particulars:—
Declared at the day of 192 .
*†
* The person before whom this declaration is made to sign here and add the title by which he takes the declaration, such as “Postmaster”, &c.
† The declaration may be made before any of the following persons:—A postmaster or postmistress, or person in charge of a post office, a police, stipendiary, or special magistrate of the Commonwealth or of a State, a justice of the peace, a barrister or solicitor, a State school head-teacher, an officer of the Department of Trade and Customs, a member of the police force of the Commonwealth or of a State, a legally qualified medical practitioner, a notary public, a commissioner for affidavits, a registrar under the Invalid and Old-age Pensions Act 1908–1923, a minister of religion, an officer of the Repatriation Department, a member of the Parliament of the Commonwealth, or a commissioned officer of the Australian Military Forces.
The foregoing claim was received by me on 192 .
Form WW.
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———
———
NOTICE OF DEATH.
To the Deputy Commissioner of Pensions at
*Insert full name and last address; also any other available particulars likely to assist in identification.
I advise that I have received notice of the death of* who died on the day of 19 , aged years, and I believe him to have been a pensioner under the Australian Soldiers’ Repatriation Act 1920–1922, whose Pension was paid at
Image unavailable in extracted textDistrict Registrar of Births, Deaths, and Marriages, or, Official charged with duty of registering deaths.
Address of the official making this report
Date 19
A regulation under the Australian Soldiers’ Repatriation Act 1920–1922 authorizes the official registering a death to inquire, when registering the death of any person, whether the deceased was a Pensioner under the Act and, if so, to notify the Deputy Commissioner. As War Pensions are granted to persons of all ages, inquiry should be made in all cases.
———
Form YY.
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———
WAR PENSION REQUISITION.
———
The Secretary,
Repatriation Commission.
I beg to apply for the following Printed Forms for the use of this office.
Deputy Commissioner of Repatriation,
Date State of
N.B.—In order to guard against any waste of Forms, &c., care should be exercised to see that reasonable quantities only, having regard to actual requirements, are applied for.
* May be printed locally.
Form ZZ.
———
———
APPLICATION FOR CHANGE OF PLACE OF PAYMENT.
(Application, accompanied by Pension Certificate, must be sent to Postmaster or other Officer who pays Pension.)
Date
Pension Certificate No.
I hereby apply that place of payment of the Pension be changed from to for the following reasons:—
My new address will be—
Signature of applicant.
———
I beg to report to the Deputy Commissioner of Pensions at that I have authorized the transfer from to . The last payment made at this office was due on “Pension Thursday”, the , 192 .
Postmaster or Paying Officer.
N.B.—Postmasters cannot authorize transfers to places outside the Commonwealth (see Clause 38 of “Instructions to Postmasters”).
Division Div 6 - Australian Soldiers' Repatriation Regulations - Register of Securities. | Zoe