STATUTORY
RULES
1934.
No. 142.
_________
REGULATIONS UNDER THE INVALID AND
OLD-AGE PENSIONS ACT 1908-1933.*
I, THE
GOVERNOR-GENERAL in and over the Commonwealth of
Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations
under the Invalid and Old-age Pensions Act 1908-1933.
Dated this seventh day of November, 1934.
ISAAC A. ISAACS
Governor-General.
By
His Excellency’s Command,
R. G. CASEY
for Treasurer,
_________
Amendment of
the Invalid and Old-age Pensions Regulations.
Repeal
of Regulations 38, 39 and 40.
1. Regulations 38,
39 and 40 of the Invalid and Old-age Pensions Regulations
are repealed.
Forms
2 and 3 repealed and new Forms substituted.
2. Forms 2 and 3 in the Invalid and Old-age Pensions Regulations are repealed and the following Forms inserted
in their stead:—
Form 2.
“Commonwealth of Australia.
The Invalid and Old-age Pensions Act 1908-1933.
OLD-AGE PENSION CLAIM.
Attention is directed to section 27 (4.) of the Act, which
reads as follows:—
Every
claimant shall, by declaration to be indorsed thereon, declare that the contents of his pension claim are true and correct in every particular,
and if in the declaration or claim he wilfully makes any statement which is untrue in
any particular, he shall be guilty of an offence.
Penalty:
One hundred pounds or imprisonment for one year.
* Name of Claimant in
full.
Residence (Postal Address).
‡ Occupation.
I,* ...........................................................................................................................................
of.........................................................................................................................................................................................
‡.............................................................................................................................................
hereby claim an Old-age Pension under the Invalid and
Old-age Pensions Act 1908-1933.
I affirm that, in respect of an
Old-age Pension, I have all the qualifications and requirements, and nave not
any of the disqualifications, under
the above-mentioned Act.
My place
of abode is at. ………………………………………………………………………. where I have resided for a period
of …………………………………………………………………… and my place or places of abode during the last
twelve months have been ………………………………………………………………………………………………………….
________________________________________________________________________________
*
Notified in the Commonwealth Gazette on
15th November, 1934.
Statutory Rules 1925, No 178; as
amended by Statutory Rules 1929, Nos. 9 and 110; 1930, Nos. 4 and 11; 1931, No. 91; 1932, No. 122; 1938, Nos.
4, 41, 53 and 144; and 1934, Nos. 12,
69, and 112.
4874.—Price 8d.
The
information given in answer to the questions hereinafter act out is true and
correct. |
QUESTIONS. | ANSWERS. |
Where
were you born? (Name
the place and country.) (If you have documentary proof of age, it should, if practicable, be attached to this
page.)
|
When
were you born? (Give
exact date if possible.)
|
If you were not horn a British subject are you naturalized? If so, when and where
were you naturalized? (Papers or other evidence must be produced to the
Magistrate.)
|
If you were not born in Australia, when did you first arrive in Australia?
|
From what port did you sail for Australia? What was the name of the ship and at what
port did you land?
|
Were you a passenger or immigrant or member of
crew? (State
which.)
|
Since you first arrived for Australia have you visited New Zealand or any other country?
|
If so, how long altogether were you away from Australia? (Give full particulars, including dates of departure from, and return to, Australia.)
|
Are you single, married, a widow a widower or a divorcee?
(State
which.)
|
If you are married what is the full name of your husband or wife?
|
Where
and when were you married? (Give
exact date if possible.)
|
If you are widow or married woman, what was your maiden name?
|
QUESTIONS. | ANSWERS. |
(in the case of married persons, information is required concerning
both husband and wife |
Information
concerning Claimant. | Information
concerning Claimant’s
Wife or Husband. |
How much
per week are you earning now? (If earning,
give name and address of employer.)
|
By
whom were you employed during the last twelve months?
|
How
much did you earn during the last twelve months?
|
Do you
receive board or lodging either free or in return for services? (State which, for how long and from whom received.)
|
How much
per week are your relatives (husband, wife, father, mother or children)
contributing towards your maintenance?
|
Do you
keep a shop or lodging-house or boarding-house, or conduct a business of any
kind, or have you an interest in any shop or business?
|
What is
the nature of the shop or business, and what were the gross receipts and
profit during the last twelve months?
|
Has anyone
agreed to maintain you wholly or partially or to make any payments to you in
consideration of property you have transferred?
|
Are you in
receipt of a War Pension or any other allowance from the Repatriation
Department or any other pensioner superannuation allowance? (If so, give full particulars.)
|
4874.—8
QUESTIONS. | Answers. (In the Case of Married Persons,
Information is required Concerning Both Husband and Wife.)
|
Information
concerning Claimant. | Information
concerning Claimant’s
Wife or Husband. |
What
other income have you received during the last twelve months? (Reply should include rents, after deduction of repairs &c.,dividends from
banks or companies, interest on bonds or on
money lent or on money in banks, income from
a deceased estate and any other form of receipts. The nature and amount of the income in each case should be stated.)
|
Have you
at any time applied for an Invalid or Old-age Pension? If so, when and where?
|
Do you own
or have you an interest in any house or land property? (Property includes freehold, leasehold and property
being purchased by instalments.)
|
If
so, where is it situated? (Give full particulars.)
|
What
is the full capital value? (Where a valuation of the property has been made
for any local authority, the last notice
of assessment or a letter from an official of such local authority, stating the capital value as assessed, must be sent,
placed to this page, to the Registrar of Pensions.)
|
If
you own or have an interest in only one house, do you live in it?
|
If
you own or have an interest in more than on a house, which of those mentioned
above do you live in?
|
Is
any of your property subject to a mortgage or other encumbrance? (If so,
state clearly which property is encumbered;
also the name and address of the person to whom the money is owing and the amount of the debt.)
|
Questions. | Answers. |
(In the Case of Married Persons, Information is Required Concerning both
Husband and Wife.). |
Information
concerning Claimant. | Information
concerning Claimant’s
Wife or Husband. |
Have
you a share or interest in any other property?
|
What
is the nature and value of each share or interest?
|
Do you own
any horses, cattle, sheep, or other live stock, or any vehicles, implements,
&c.? (Give particulars and value.)
|
Have you
any interest in a deceased estate, or under any settlement, deed of gift, or
deed or declaration of trust? (Give full particulars.)
|
Have
you any money in any bank, savings bank, building society, or other institution,
or any money in hand? (If so, give details as to amounts, name and address
of bank, &c.)
|
Is
your life insured? (If so, state name of company, policy number, amount, and age at which amount payable also state by whom premiums are paid.)
|
Do
you own any Government or other bonds or stock or industrial shares, or have
you lent money to any person on mortgage or in any other manner? (If
so, give particulars.)
|
Have
you any real or personal property not elsewhere disclosed in this statement?
(If so, give particulars.)
|
Have you
during the past five years transferred or otherwise disposed of money or
other property of any kind? (If so, give particulars how disposed of and to whom, and
the value received therefor.)
|
At
what Post Office do you desire your pension, if granted, to be paid?
|
Signature of Claimant...................................................
Declaration
* Name of Claimant.
Residence and
Occupation.
I,*...........................................................................................................................................
of ..........................................................................................................................................
...............................................................................................................................................
the above-named claimant for an Old-age Pension under the Invalid
and Old-age Pensions Act 1908-1933 do hereby declare that the contents of
my pension claim on which this declaration is indorsed are true and correct in
every particular.
Declared
at........................ |
(Signature of Declarant.) |
the..........day of.........19 |
Before
me—
‡§.....................................................................
.............................................................
‡The person on before whom this declaration is made to
sign here and add the title by which be 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 permanent officer of the Postmaster-General’s Department
whose duties include
the payment of invalid or old-age pensions, 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 commissioner for declarations, a registrar under the Invalid
and Old-age Pensions Act 1908-1933, a minister of religion, an officer of the Commonwealth
Department of the Treasury, a councillor of any municipality or shire, or a member of the Parliament of
the Commonwealth or of any State.
______
Form 3.
“Commonwealth of Australia.
The Invalid and Old-age Pensions Act 1908-1933.
INVALID PENSION CLAIM.
Attention is directed to section
27(4.) of the Act, which reads as follows:—
Every claimant shall, by declaration
to be indorsed thereon, declare that the contents of his pension claim are true and correct in every particular, and if in the declaration or claim he wilfully makes any statement
which is untrue in any particular, he shall be guilty of an offence. Penalty:
One hundred pounds or imprisonment for one
year.
*
Name of Claimant in full.
Residence (Postal Address).
‡ Occupation.
I,*...........................................................................................................................................
Of..........................................................................................................................................
‡.............................................................................................................................................
hereby claim an Invalid Pension under the Invalid and
Old-age Pensions Act 1908-1933.
I
affirm that, in respect of an Invalid Pension, I have all the qualifications
and requirements, and have not any of the disqualifications, under the
above-mentioned Act.
My place of abode is at ……………………………………………………………………………….
where I have resided for a period of…………………………………………………………………… and my place or
places of abode during the last twelve months have been
…………………………………………………………………………………………………………
The
information given in answer to the questions hereinafter set out is true and
correct.
QUESTIONS. | ANSWERS. |
Where
were you born? (Name
the place and country.)
|
When
were you born? (Give
exact date if possible.)
|
If you
were not born a British subject are you naturalized? If so, when and where were you naturalized? (Papers or
other evidence must be produced to the Magistrate.)
|
If
you were not born in Australia, when did you first arrive in Australia?
|
From
what port did you sail for Australia? What was the name of the ship and at
what port did you land?
|
Were
you a passenger or immigrant or member of crew? (State which.)
|
Since
you first arrived in Australia have you visited New Zealand or any other country?
|
If
so, how long altogether were you away from Australia? (Give
full particulars, including dates of departure from, and return to, Australia.)
|
Are
you single, married, a widow, a widower, or a divorcee? (State
which.)
|
If
you are married, what is this full name of your husband or wife?
|
Where
and when were you married? (Give
exact date if possible.)
|
If
you are a widow or married woman, what was your maiden name?
|
QUESTIONS. | ANSWERS. |
(In The Case of Married Persons, Information is Required Concerning Both
Husband And Wife.) |
Information concerning Claimant. | Information concerning Claimant’s
Wife or Husband. |
How
much per week are you earning now? (If earning, give name and address of employer.)
|
By when
were you employed during the last twelve months?
|
How
much did you earn during the last twelve months?
|
Do
you receive board or lodging either free or in return for services? (State which, for how long and from whom received.)
|
How much
per week are your relatives (husband, wife, father, mother or children)
contributing towards your maintenance?
|
Do you
keep a shop or lodging-house or boarding house or conduct a business of any
kind, or have you an interest in any shop or business?
|
What is
the nature of the shop or business, and what were the gross receipts and
profit during the last twelve months?
|
Has anyone
agreed to maintain you wholly or partially or to make any payments to you in
consideration of property you have transferred?
|
Are you in
receipt of a War Pension or any other allowance from the Repatriation
Department or any other pension or superannuation allowance? (If
so, give full particulars.)
|
Questions. | Answers. |
(In The Case of married Persons, information is Required Concerning Both
Husband and Wife.) |
Information
concerning Claimant. | Information
concerning Claimant’s Wife or Husband. |
What other
income have you received during the last twelve months? (Reply should include rates, after deduction of repairs, &c., dividends from banks or companies, interest on bonds or money lent or on money in banks, income from a deceased estate, and any, other form of receipts. The nature and amount
of the income in each case should be stated.)
|
Have you
any claim against any employer, company, or any other person, or body to
maintain or compensate you on account of accident or invalid state of health? (If
so, state full particulars.)
|
Have
you ever received compensation on account of accident or ill-health? (If
so, state full particulars.)
|
Have
you at any time applied for an Invalid or Old-age Pension? If so, when, and where?
|
Do you own
or have you an interest in any house or land property? (Property includes
freehold, leasehold and property being purchased by instalments.)
|
If
so, where is it situated? (Give
full particulars.)
|
What
is the full capital value? (Where a valuation of the property has been made
for any local authority, the last notice
of assessment or a letter from an official of each local authority, stating the capital value as assessed, must, he sent,
pinned to this page, to the Registrar of Pensions.)
|
If you own
or have an interest in only one house, do you live in it?
|
Questions. | Answers. |
(In The Case Of Married Persons,
Information Required Concerning Both Husband And Wife.) |
Information
concerning Claimant. | Information
concerning Claimant’s
Wife or Husband. |
Ifyou own or have an interest in
more than one house, which of those mentioned above do you live in?
|
Is any of
your property subject to a mortgage or other encumbrance? (If so,
state clearly which property is encumbered;
also the name and address of the person to whom the money is owing and the amount of the debt.)
|
Have
you a share or interest in any other property?
|
What
is the nature and value of such share or interest?
|
Do you own
any horses, cattle, sheep, or other live stock, or any vehicles, implements,
&c.? (Give
particulars and value.)
|
Have you
any interest in a deceased estate, or under any settlement, deed of gift, or
deed or declaration of trust? (Give
full particulars.)
|
Have you
any money in any bank, savings bank, building society, or other institution,
or any money in hand? (If to, give details as to amounts, name and address
of bank, &c.)
|
It
your life insured? (If so, state name of company, policy number, amount, and age at which amount payable; also state by whom premiums are paid.)
|
Do you own
any Government or other bonds or stock or industrial shares, or have you lent
money to any person on mortgage or in any other manner? (If
so, give particulars.)
|
Questions. | ANSWERS. (In The Case of Husband Persons, Information is Required Concerning
Both Husband and Wife.) |
Information
concerning Claimant. | Information
concerning Claimant’s
Wife or Husband. |
Have you
any real or personal property not elsewhere disclosed in this statement? (If
so, give particulars.)
|
Have you
during the past five years transferred or otherwise disposed of money or
other property of any kind? (If so,
give particulars how disposed of and to
whom, and the value received therefor.)
|
At what
Post Office do you desire your pension, if granted, to be paid?
|
Signature
of claimants......................................................................................
_______
Declaration.
*
Name of Claimant.
Residents and occupation.
I,*...........................................................................................................................................
of ..........................................................................................................................................
...............................................................................................................................................
the above-named claimant for an Invalid Pension under the Invalid
and Old-age Pensions Act 1908-1938 do hereby declare that the contents of
my pension claim on which this declaration is indorsed are true and correct in
every particular.
Declared at...........................
|
the.........day of.........19
| (Signature of Declarant.)
|
Before me—
‡§.....................................................................
.............................................................
‡ 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 permanent officer
of the Postmaster-General’s Department whose duties include the payment of invalid or old-age
pensions, 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
commissioner for declarations, a registrar under the Invalid and Old-age Pensions
Act 1908-1933, a minister of religion, an officer of the
Commonwealth Department of the Treasury, a councillor of any municipality or shire, or a member of
the Parliament of the Commonwealth or of any State.”.