Invalid and Old-age Pensions Regulations (Cth)
STATUTORY RULES.
REGULATIONS UNDER THE INVALID AND OLD-AGE PENSIONS ACT 1908-1926.
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
Dated this seventeenth day of December, 1926.
STONEHAVEN,
Governor-General.
ByHis Excellency’s Command,
THOS. W. CRAWFORD,
for Treasurer.
INVALID AND OLD-AGE PENSIONS REGULATIONS.
Part I.—Introductory
Part I.—Introductory.
Part II.—Lodging, Investigation, and Determination of Claims.
Part III.—Payment of Pensions.
Part IV.—Miscellaneous.
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
C.15061.—Price 1s.
medical practitioner, a notary public, a commissioner for affidavits, a commissioner for declarations, a registrar, 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.
(2) If any person wilfully makes any false statement in any declaration provided for under these Regulations he shall, if subject to no higher penalty under the Act, be liable to a penalty not exceeding One hundred pounds.
Part II.—Lodging, Investigation, and Determination of Claims.
(1) a pension claim in accordance with Form 2, if claim is made for an Old-age Pension, or a pension claim in accordance with Form 3 if claim is made for an Invalid Pension;
(2) a declaration, in accordance with Form 4, made by a person acquainted with the claimant; and
(3) an identification card in accordance with Form 5.
Provided that in any case in which it appears that documentary evidence as to the claimant’s age is not easily obtainable, it shall not be necessary for the Registrar to make further inquiries on the point if he believes that the age qualification will be obvious when the claimant appears before the Magistrate.
(2) In the case of a permanently blind claimant the amount of pension which may be recommended shall be calculated by deducting from Two hundred and twenty-one pounds or from such other amount as is declared by any Act or by any authority constituted under an Act to be a basic wage for the portion of the Commonwealth in which the claimant resides, the amount of the income of the claimant and of the claimant’s wife or husband, as the case may be, including income from accumulated property, and from the balance remaining, or from Fifty-two pounds, whichever is lower in amount, there shall be deducted an amount, calculated as directed in sub-section (2) of section 24 of the Act, in respect of the net capital value of the claimant’s accumulated property.
(2) Subject to paragraph (3) of this regulation, the Registrar shall send to the Deputy Commissioner the papers and the evidence received from the Magistrate together with the identification card.
(3) In cases where the recommendation by the Magistrate for the rejection of the claim shows that no material point has been disproved, bat that some material points have not been proved or have not been sufficiently proved, the Registrar shall retain the papers for one month, or until he has received from the claimant a notice in accordance with Form 19 of intention to adduce fresh evidence, in which case the matter shall be dealt with as prescribed by section 32 of the Act. if a notice in accordance with Form 19 has not been received, or if the notice has been received and the case has been dealt with as directed, the Registrar shall forthwith forward the papers, evidence and identification card to the Deputy Commissioner,
(2) Where it is necessary to ask the police for a report regarding income and property statements, the request to the police shall be in accordance with Form 25.
Part III.—Payment of Pensions.
Provided that where money is payable to a pensioner while he is an inmate of a benevolent asylum or hospital the pension certificate shall be in such form as is directed by the Commissioner and it shall not be necessary to prepare an identification card in accordance with Form 5.
Provided that, as regards the method of paying, the postmaster or other officer shall follow such instructions as are from time to time issued by the Commissioner:
Provided also that, if so instructed by the Commissioner or Deputy Commissioner, the postmaster or other officer shall not make payment of the pension.
Provided that the amount of pension payable in respect of the fortnight which commenced on 28th April, 1921, shall be not more than one-half of the usual fortnightly instalment.
(2) Every such fortnight shall be known as a “pension fortnight,” and the first day of every “pension fortnight” shall be known as “Pension Thursday,”
(2) Any moneys due to a pensioner on his discharge from a hospital or a benevolent asylum shall be deemed to be one instalment, and the due date thereof shall be the day of the pensioner’s discharge from the institution.
the identification card by post to the office to which payment is to be transferred. Upon receipt of the identification card, the postmaster or other officer at the office to which payment has been transferred shall, subject to any instructions issued by the Commissioner or Deputy Commissioner, make payment of the pension as it falls due.
(2) The application in accordance with Form 28 shall, if approved by the postmaster or other officer, be transmitted to the Deputy Commissioner.
(3) A pensioner shall not, without the permission of the Deputy Commissioner, be allowed to change the office of payment more than twice in any calendar year.
Provided that, if approved by the Deputy Commissioner, payment may be made to the holder of a warrant who has not seen the pensioner within the preceding three months.
(2) The warrant shall be in accordance with Form 34 and shall continue in force until a date to be named therein or until otherwise ordered by the Deputy Commissioner.
(3) Where the Deputy Commissioner considers it expedient to do so, he may issue a warrant in accordance with Form 34 notwithstanding that an application in accordance with Form 33 has not been made.
(2) When any pensioner becomes an inmate of a benevolent asylum, payment of his pension shall be suspended and the Commissioner or Deputy Commissioner shall direct a Magistrate to re-hear the claim. If as a result of the re-hearing the Commissioner or Deputy Commissioner is of opinion that the pensioner intends to remain permanently in the benevolent asylum he shall cancel the pension and shall authorize the payment to the inmate of a pension at the rate of Four shillings per week. If the Commissioner or Deputy Commissioner is of opinion that the pensioner does not intend to remain permanently in the benevolent asylum the pension shall remain suspended, but when the pensioner has remained an inmate for a period of twenty-eight days he shall upon the expiration of that period and so long thereafter as he remains an inmate be entitled to a pension at the rate of Four shillings per week.
(2) On receipt of notice of discharge in accordance with Form 36 the postmaster or other officer may resume payment of the pension, and in a case in which the pensioner has been an inmate of the benevolent asylum or hospital for a period of not more than four weeks he shall be entitled to payment of his pension for the whole of that period; but in a case in which the pensioner has been an inmate for a longer period he shall in respect of the period during which he was an inmate be entitled on discharge to payment of his pension for the first twenty-eight days of his stay in the institution:
Provided that in any case in which a pensioner has been an inmate of a benevolent asylum, the postmaster or other officer shall not make any payment unless so directed by the Commissioner or Deputy Commissioner.
(3) In any case in which a pensioner has been an inmate of a benevolent asylum, hospital, or asylum for the insane for a period of more than four weeks the calculation of the amount of pension payable on his discharge shall be made in accordance with Form 37.
(2) Notice of the alteration in accordance with Form 39 shall also be forwarded by the Deputy Commissioner to the pensioner or other person authorized to receive payment.
Part IV —Miscellaneous.
(2) In this Regulation Registrar of Deaths means any Commonwealth or State officer charged with the duty of registering deaths.
Form 1.
COMMONWEALTH OF AUSTRALIA.
———
The
———
DECLARATION.
I, do solemnly and sincerely promise and declare that I will, according to law and to the best of my knowledge and ability, discharge the duties of the office of* under the above-named Act.
Declared at this day of 19 before me
* Fill in nature of office.
Strike out what is inapplicable.
———
Form 2.
COMMONWEALTH OF AUSTRALIA.
———
The
———
OLD-AGE PENSION CLAIM.
Attention is directed to the following:—
Section 27, sub-section 4 of the Act reads:—
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: £100or imprisonment for one year.
I,
of
‡
hereby claim an Old-age Pension under the above Act.
I affirm that, in respect of an
Old-age Pension, I have all the qualifications and requirements and have not
any of the disqualifications under the
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 ?
| |
| |
When were you born ?
| |
| |
From what port did you sail for Australia | |
What was the name of the ship ? | |
At what port did you land ? | |
|
Questions. | Answers. |
| |
| |
Are you single, married, widow, or widower ?
| |
| |
Where and when were you married ?
| |
|
What are the names, dates of birth, places of birth, &c., of all your children ?—
Names of Children. | Dates of Birth. | Places of Birth. (Show name of State as well as Place.) | Places where Births Registered. | |||||
Questions— | Answers— | |||||||
| ||||||||
| ||||||||
| ||||||||
Were you born a British subject? | ||||||||
(Papers or other evidence must be produced to the Magistrate.) | ||||||||
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?
| ||||||||
| ||||||||
| ||||||||
| ||||||||
| ||||||||
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 house or land property do you own? | ||
Where is it situated?..................................................... | ||
What is the nature of the title?.................................... | ||
What is the full capital value?....................................
| ||
If you own only one house, do you live in it? | ||
| ||
| ||
| ||
What is the nature and value of such property? | ||
| ||
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. | |
Do you own any furniture, vehicles, &c.?
| ||
| ||
Is your life assured?
| ||
| ||
| ||
| ||
DECLARATION.
I,* of
do
hereby declare that I am the claimant for an Old-age Pension under the
Declared at the day of 19 | ( |
Before me,
§ ‡
* Name of Claimant.
Residence and occupation.
‡ 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 commissioner for declarations, a
registrar under the
COMMONWEALTH OF AUSTRALIA. Form 3.
———
The
INVALID PENSION CLAIM.
Attention is directed to the following:—
Section 27, sub-section 4, of the Act reads:—
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: £100or imprisonment for one year.
I *
of
‡
hereby claim an Invalid Pension under the above Act.
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
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?
| |
When were you born?
| |
| |
From what port did you sail for Australia? | |
What was the name of the ship? | |
At what port did you land? | |
| |
| |
| |
Are you single, married, widow, or widower?
| |
| |
Where and when were you married?
| |
| |
| |
| |
Were you born a British subject? | |
| |
|
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? | ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
| ||
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 house or land property do you own? | ||
Where is it situated? | ||
What is the nature of the title? | ||
What is the full capital value? | ||
| ||
If you own only one house, do you live in it? | ||
| ||
| ||
| ||
| ||
What is the nature and value of such property? | ||
| ||
| ||
Do you own any furniture, vehicles, &c.? | ||
| ||
| ||
| ||
Is your life assured? | ||
| ||
| ||
| ||
| ||
| ||
DECLARATION,
I*
of
do
hereby declare that I am the claimant for an Invalid Pension under the
Declared at the day of 19 | ( |
Before me,
§ ‡
* Name of Claimant.
Residence and occupation.
‡ 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 commissioner for declarations, a registrar
under the
————
Form 4.
COMMONWEALTH OF AUSTRALIA.
——
The
——
DECLARATION BY PERSON WHO HAS KNOWN CLAIMANT FOR A LENGTHENED PERIOD.
attention is directed to the following:—
(
a ) Every claimant is expected to send to the Registrar of Pensions a declaration made by a person who has known claimant for a period of at least 20 years in the case of a claimant for an Old-age Pension, and 5 years in the case of a claimant for an Invalid Pension, but if no such person can be found the declaration may be made by a person of shorter acquaintance.(
b )Declarant should not be a relative of claimant.
(
No person shall by any wilfully false statement or representation aid or abet any person in obtaining or claiming a pension certificate or pension, or instalment of a pension. Penalty—£100, or six months’ imprisonment.
Name, Address, and Occupation of Claimant for Pension.
I, do solemnly and sincerely declare that the (Name, address, and occupation of declarant.)
information given in this form, in relation to the above-named claimant for a pension, is to the best of my knowledge and belief, true and correct in every particular.
How long have you known claimant? |
In what places have you known claimant? Are you related to claimant?
|
How has claimant been maintained latterly?
If claimant is applying for an Invalid Pension—
If claimant is married—
|
Declared at this day of 19
* |
* 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 commissioner for declarations, a
registrar under the
——
Form 5. Pension Certificate No. Pensioner’s Name Pension at the rate of fortnightly granted, payable at The Pensioner was first entitled to payment on “Pension Thursday,” the 19 for the fortnight commenced on that date. Date | Payment to be made in future at The last payment made at this office was due on “Pension Thursday,” the | 19 . |
|
| Payment to be made in future at The last payment made at this office was due on “Pension Thursday,” the | 19 . |
|
| Payment to be made in future at The last payment made at this office was due on “Pension Thursday,” the | 19 . |
|
|
This Card to be forwarded by the Registrar to the Deputy Commissioner who, if pension approved, will send it to a Postmaster or other Paying Officer. The last-named must retain the Card as his authority for paying pension. [The Card should not be Folded.]
Form 5. Particulars for identification of pensioner. | Name of Claimant in full | |
Date of Birth | Place of Birth | |
Postal Address | ||
Last Occupation | ||
Number of Children | of whom | are living |
Name of Claimant’s Father | ||
Maiden Name of Claimant’s Mother | ||
Signature of Claimant | ||
|
C.15061.—2
Form 6.
COMMONWEALTH OF AUSTRALIA.
——
The
——
DISTRICT REGISTER OF PENSION CLAIMS.
Date of Receipt of Claim. | Surname. | Christian Name. | Occupation. | Address. | Date when finally dealt with by Magistrate. | Nature of Magistrate’s Recommendation. | Date when Claim and Magistrate’s Recommendation sent to Deputy Commissioner. | Short Particulars of Income and Property as accepted by Magistrate. | Remarks. |
————
Form 7.
COMMONWEALTH OF AUSTRALIA.
————
The
CONFIDENTIAL REPORT—GENERAL.
Full Name of Claimant for Pension
Address of Claimant
——
From the Registrar of Pensions at
To
The above-named is a claimant for a pension, and I have to request that you will be so good as to inform me as follows:—
It is requested that your reply be written hereunder.
From
To the Registrar of Pensions at
Form 8.
COMMONWEALTH OF AUSTRALIA.
The
——
CONFIDENTIAL REPORT—BANK.
From the Registrar of Pensions at
To the Manager, Bank of
The persons named in the attached Schedule are pensioners or claimants for pensions under the above-named Act, and I have to request you will be so good as to show in the Schedule particulars of any money or securities held by you on account of such persons. I may inform you that in section 28 sub-section (2) of the Act, it is provided as follows:—
Schedule Referred to Above.
Names in Full. | Addresses in Full. | Particulars of Money or Securities | |
Now held. | Withdrawn from Bank during the previous twelve months. | ||
From the Manager, Bank of
To the Registrar of Pensions at
I certify, after due inquiry, that to the best of my knowledge and belief, the particulars of money or securities shown in the Schedule above are correct.
Form 9.
COMMONWEALTH OF AUSTRALIA.
——
The
——
SEARCH FOR PARTICULARS AS TO AGE OR ARRIVAL IN AUSTRALIA.
From the Registrar of Pensions at
To the Deputy Commissioner of Pensions at
* Please cause the date of arrival in Australia to be verified in the following case.
* Please cause search to be made in order to ascertain the age of the claimant, who has given the following information with regard to his (or her) children.
Registrar of Pensions at Date
Present Name of Claimant (in fall)
Name on ship’s books | Immigrant Passenger Member of Crew |
Name of ship from the port of to the port of Date of arrival at latter port
Full Names. | Dates of Birth. | Places of Birth.‡ (Name of State required as well as Name of Place.) | Claimant’s Age then given. | Wife’s (or Husband’s) Age then given. | Registered by | Birthplace of (H) Husband, or (W) Wife. |
From the Deputy Commissioner to the Registrar—
Date of arrival |
cannot be traced. |
Details as to ages have been supplied above.
* If claimant is able to produce satisfactory evidence as to age, the second request should be struck out. If claimant is able to produce satisfactory evidence as to arrival in Australia, the first request should be struck out.
Strike out what is incorrect.
‡ State also places of registration if not registered at places where born.
Form 10.
COMMONWEALTH OF AUSTRALIA.
——
The
To the Officer in Charge of Police at
Claimant—
Name
Occupation
Address
It is requested that you will be good enough to make all such inquiries as may be necessary for a full investigation of a claim for an Old-age*/Invalid* Pension made by the above-named, and to forward to me a report on this form with as little delay as may be. The inquiries should be made as far as possible from persons other than the claimant or the claimant’s relatives.
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 “Pensions.”
Questions on this page only to be answered in case claimant is applying for Invalid Pension.
Questions. | Answers. |
| |
Does it incapacitate claimant for any work? | |
| |
| |
| |
| |
How long ago was this? | |
| |
| |
In your opinion, what is claimant’s age? | |
| |
| |
| |
Is the claimant a natural-born British subject? |
* Strike out what is inapplicable.
20 years is the qualification necessary for an Old-age Pension claimant: 5 years for an Invalid Pension claimant. Strike out which is inapplicable.
Questions. | Answers. | |||
| ||||
Were naturalization papers produced to you?
| ||||
| ||||
Is claimant of good character?
| ||||
| ||||
These questions need not be answered in respect of claimants for Invalid Pensions. |
| |||
| ||||
Questions. | Answers. | |||
In case of married claimant, answers to questions on this page should relate to property and income of both husband and wife. | ||||
Husband. | Wife. | |||
| ||||
| ||||
| ||||
Questions. | Answers. | |||
In case of married claimant, answers to questions on this page should relate to property and income of both husband and wife. | ||||
Husband. | Wife. | |||
| ||||
| ||||
Does the claimant receive free board or lodging?
| ||||
| ||||
| ||||
| ||||
| ||||
| ||||
Questions. | Answers. | |||
| ||||
| ||||
Are husband and wife living together?
| ||||
| ||||
| ||||
| ||||
| ||||
| ||||
I have made inquiries in the matter of this claim, and, to the best of my knowledge and belief, the information given in this document is correct.
(Insert here name and rank of Member of Police Force who has made inquiries.)
From the Officer in Charge of Police at
To the Registrar of Pensions at
Above report is forwarded for your information.
Form 11.
COMMONWEALTH OF AUSTRALIA.
——
The
——
NOTICE TO ATTEND INVESTIGATION.
To
Address
Take notice that the investigation of your pension claim will be made on day, the day of 19 , at the Courthouse* at at o’clock in the noon, and that you are then and there required to attend and to support your claim by the production of papers or other evidence.
Dated at this day of 19
Form 12.
COMMONWEALTH OF AUSTRALIA.
——
The
——
Sir,
I have the honour to inform you that*
have made claims for pensions, and that they have been requested to appear before you at the Court-house,‡ at on
at o’clock in the noon.
Registrar.
To Esq.,
Magistrate.
* Names of Claimants.
If not requested to attend, alter wording to agree with the facts.
‡ Alter this word if investigation is to be made at a place other than a Court-house.
Form 13.
To the Magistrate at
The attached claim is forwarded to you, together with the following reports and documents:—
* The claimant is unable to attend by reason of
* Strike out if not required.
Form 14.
COMMONWEALTH OF AUSTRALIA.
——
The
——
Office of Registrar of Pensions.
(Date)
Memo. to
In reference to your claim for a pension, you are requested to attend at for medical examination by between the hours of a.m. and a. m on p. m. p. m the taking this notice with you. The fee for this examination will be paid by the Commonwealth.
You must attend at the appointed time or notify me at once of your inability to do so.
Registrar of Pensions.
Form 15.
COMMONWEALTH OF AUSTRALIA.
——
The
——
Office of Registrar of Pensions.
(Date)
Memo. to Dr.
(Commonwealth Medical Referee),
Name and Address of Claimant
The above-named has made a claim for an Invalid Pension, and
* | (has been requested to call on you for examination between the hours of a. m. and a.m. on p. m. p.m. |
you are requested to visit claimant at the address set out and there make the necessary examination. |
Kindly forward direct to this office the result of your examination in accordance with Form 16.
In rendering your account half-yearly to the Deputy Commissioner you are requested to attach this notice thereto. The fee chargeable in the ease of a claimant attending your consulting rooms is 10s., and in the case of your visiting claimant, 15s.
Registrar of Pensions.
* The Registrar to strike out what is inapplicable.
Form 16.
COMMONWEALTH OF AUSTRALIA.
——
The
——
MEDICAL CERTIFICATE FOR INVALID AND OLD-AGE PENSION PURPOSES.
I,
hereby declare that I have this day examined
of a claimant for
a pension under the above-named Act.
I find that the claimant—
(1) Is about years of age.
(2) Is suffering from (
a )(3) The above (
b ) is the result of (c )(4) It has in my opinion existed for (
d ) and has not been self-induced.(5) The (
e ) is such / is not such as to render claimant “permanently incapacitated for work, or blind.”
I therefore certify that, after
full and careful examination, I am of opinion that claimant is / is not
permanently incapacitated for work or blind, and is / is not in that respect
entitled to a pension under the
(
Address )
Date 19
* Attention is directed to the specific requirements of the Act in all cases coming within its provisions namely, that the accident or invalid state of health must be:—
(1) Permanent, and (2) Such as to incapacitate the claimant for work.
Note.—Cases
of a transient nature, only
To The
Registrar of Pensions.
Form 17.
RECOMMENDATION OF MAGISTRATE.
Hereunder I specify all the material points which I find to be respectively proved, disproved, and unproved or insufficiently proved:—
Claimant is a—
| * | Proved (by ) Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
|
* | Proved. Disproved. Unproved or Insufficiently Proved. | |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
* I recommend the rejection of the claim.
* I am satisfied that the claimant is deserving of a pension, and I recommend that a pension of £ per annum be granted.
* It appears to me that the claimant, although otherwise qualified for, is unfit to be intrusted with, a pension, and I recommend that the claimant be sent to a benevolent asylum or charitable institution.
* Strike out what is inapplicable.
Form 18.
RECOMMENDATION OF MAGISTRATE.
Hereunder I specify all the material points which I find to be respectively proved, disproved, and unproved or insufficiently proved:—
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
| * | Proved. Disproved. Unproved or Insufficiently Proved. |
* I recommend the rejection of the claim.
* I am satisfied that the claimant is deserving of a pension, and I recommend that a pension of £ per annum be granted.
* It appears to me that the claimant, although otherwise qualified for, is unfit to be entrusted with, a pension, and I recommend that the claimant be sent to a benevolent asylum or charitable institution.
Magistrate at Date
* Strike out what is inapplicable.
Form 19.
COMMONWEALTH OF AUSTRALIA.
——
The
——
NOTICE OF INTENTION TO ADDUCE FRESH EVIDENCE.
From*
To the Registrar of Pensions at
I hereby give notice that on the day of 19 I intend to adduce before the Magistrate at fresh evidence in respect of matters found by the Magistrate on the day of 19 to be unproved or insufficiently proved. The fresh evidence will be
Signature of Claimant
Date
* State full name, address, and occupation of claimant.
Set out the nature of the evidence to be adduced.
Form 20.
COMMONWEALTH OF AUSTRALIA.
——
The
——
APPEAL TO MINISTER.
To the Treasurer of the Commonwealth of Australia.
I,*
do hereby appeal to the Minister against the recommendation of the Magistrate at with regard to and in connexion therewith submit the following‡
Signature of Claimant
Date
* State name, occupation, and address.
State matters appealed against.
‡ State facts in support of appeal.
Form 21.
COMMONWEALTH OF AUSTRALIA.
——
The
——
NOTICE OF THE GRANT OF PENSION
To
I have to acquaint you that your claim for a pension has been allowed, and a pension certificate will be issued to you on application to the Postmaster at You are entitled to payment in advance as from at the rate of per fortnight. The total amount already due to you, including the fortnightly instalment due on , is £
Deputy Commissioner of Pensions.
Place
Date 19
Special attention is invited to the notice on the back hereof.
[Back of Form]
NOTICE TO PENSIONERS.
The amount of a pension is liable
to be affected by changes in the income or property of a pensioner or his wife
(or husband)—see sections 24 and 26 of the
In order to avoid danger of overpayment and consequent necessity for a refund by the pensioner, pensioners should notify the Deputy Commissioner of Pensions of any change in their financial circumstances (including those of pensioner’s wife or husband).
The following are examples of cases which should be brought under notice: Increase in income, increase in banking account, change of address when pensioner has been living in a home owned by himself or his wife (or husband), receipt of money from sale of houses or land, legacy, insurance, or other source.
Form 22.
————
Form 22.
COMMONWEALTH OF AUSTRALIA.
——
The
——
NOTICE OF REJECTION OF CLAIM.
To
I have to acquaint you that your claim for a pension has been rejected on the ground that
Deputy Commissioner of Pensions.
Place
Date 19
Form 23.
COMMONWEALTH OF AUSTRALIA.
——
The
——
INCOME AND PROPERTY STATEMENT.
The pensioner must answer fully and correctly the questions contained herein, and make the declaration before one of the persons mentioned. The form, when completed, should be returned immediately to the Deputy Commissioner of Pensions. An envelope addressed to the Deputy Commissioner will be handed to the pensioner by the Postmaster.
Should the form not be returned within four weeks, payment of pension will be stopped.
Clause 5 (2.) of the Invalid and Old-age Pensions Regulations reads:—
If any person wilfully makes any false statement in any declaration provided for under these Regulations he shall, if subject to no higher penalty under the Act, be liable to a penalty not exceeding One hundred pounds.
Note.—Where the pensioner is married, information is required concerning both husband and wife.
Questions. | Answers. | |
Information concerning the Pensioner. | Information concerning the Pensioner’s Wife or Husband. | |
What is your full name?................................................... | ||
At what post office is your pension paid? | ||
What is your pension certificate number? | ||
What is your fortnightly rate of pension? | ||
| ||
If married, is your husband or wife a pensioner? | ||
Are you at present in employment?................................
| ||
| ||
| ||
| ||
| ||
| ||
| ||
What house or land property do you own?
| ||
If you own only one house, do you live in it? | ||
| ||
| ||
Questions. | Answers. | |
Information concerning the Pensioner. | Information concerning the Pensioner’s Wife or Husband. | |
| ||
| ||
Do you own any vehicles, implements, &c.
| ||
Is your life assured?
| ||
| ||
| ||
Does any person owe you money?....................................
| ||
| ||
What is your present postal address?................................ | ||
——
DECLARATION.
I*
of
do hereby declare that I am the pensioner whose income and property are set out in the foregoing statement, and that the contents of such statement are true and correct in every particular.
Declared at the day of 19 | ( |
Before me‡
* Full name of pensioner.
Address and occupation.
‡
Person before whom declaration is made to add title, such as “Postmaster,”
&c
Note.—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 commissioner for declarations, a
registrar under the
Form 24.
COMMONWEALTH OF AUSTRALIA.
———
The
The Postmaster,
Under separate cover I am forwarding a supply of Income and Property Statements in respect of certain pensioners paid at your office—also a number of envelopes addressed “Deputy Commissioner of Pensions .”
On the occasion of the next payment, you will please hand a statement to each pensioner, together with an addressed envelope, and at the same time request the pensioner to fill in and return the document to the Deputy Commissioner of Pensions without delay.
Place
Date
COMMONWEALTH OF AUSTRALIA.
Form 25.
The
The Officer in Charge of Police, Date
Hereunder are the names of some pensioners in your district, together with particulars of the income and property which, according to departmental papers, are possessed by the pensioners and their wives or husbands. I shall be glad if you will kindly indicate whether the police are aware of any income or property not mentioned in this list. It is not expected that the police should visit every pensioner’s home. What is desired is information which may already be in possession of the police as to any cases in which it would seem that the Department has been given incorrect information.
Name of Pensioner and Pensioner’s Wife (or Husband). | Address. | Annual Income. | Property. | ||||||||
Earnings. | Rents. | Other Income. | Total. | Home. | Other Houses and Land. | Cash in Bank. | Live Stock. | Other Property. | Total. | ||
Form 26.
COMMONWEALTH OF AUSTRALIA.
——
The
——
INVALID OR OLD-AGE PENSION CERTIFICATE.
I certify that a pension, as detailed on the other side hereof, has been granted. The first fortnight’s instalment of the pension was due on 19 for the fortnight commenced on that date.
Deputy Commissioner.
The pension is payable only at the office named herein, and no application for temporary transfer to another office will be entertained.
The
following instructions must be strictly adhered to:—A person authorized by warrant in Form 34 to receive
payment for the benefit of a pensioner
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. Any
instalment not applied for within 21
Transfers to another office of payment should be noted hereunder:—
Payment to be made in future at— | Signature of Postmaster. | Date. |
Pension Certificate Number Pensioner’s Name
Fortnightly Rate shillings pence, payable at
Pensioner’s Signature (or witnessed mark) | Witness to Mark |
The
“Every pension shall be deemed to be granted and shall be held subject to all the provisions of this Act, and to the provisions of any other Act amending or repealing or in substitution for this Act which may at any time be passed, and no pensioner shall have any claim for compensation or otherwise by reason of his pension being affected by the operation of this Act or any such other Act.”
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). When, for example, the instalment due on , is paid, the date stamp must be placed in the space in which the date , is printed.
Form 27.
COMMONWEALTH OF AUSTRALIA.
——
The
——
APPLICATION FOR DUPLICATE PENSION CERTIFICATE.
To the Deputy Commissioner of Pensions at
1,
of
being a pensioner 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. The last instalment of the pension paid to me was that due on
6. I do hereby solemnly declare that this statement is true.
before me—
|
* Strike out what is inapplicable.
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 declaration, such as “Postmaster,” &c.
§
The declaration may be made before any of the following persons:—Apostmaster 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 commissioner for declarations, a registrar under the
Form 28.
COMMONWEALTH OF AUSTRALIA.
——
The
——
APPLICATION FOR CHANGE OF PLACE OF PAYMENT.
(Application, accompanied by pension certificate, must be sent to Postmaster or other officer who pays pension.)
Address
Date
Pension Certificate No.
I hereby apply that place of payment of my 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 , and the Identification Card, duly endorsed, has been forwarded to the Postmaster. The last payment made at this office was due on “Pension Thursday,” the 19 at the rate of p. f.
Rate of pension to be shown in all cases.
N.B.—Postmasters cannot authorize transfers to places outside the Commonwealth.
Pension Certificate No. Form 29.
| Post Office Date Stamp to be |
| |
| |
| |
placed in this square. |
I acknowledge to have received the sum of £ : : being fortnightly pension instalment due on in accordance with Pension Certificate numbered as above.
Note.—Whenever
payment of a pension instalment is made, the paying officer will hand to the
pensioner a blank form of receipt, which must be brought back on the next
pension pay-day,
The attention of pensioners is drawn to notice on back.
[Back of Form.]
NOTICE TO PENSIONERS.
The amount of a pension is liable
to be affected by changes in the income or property of a pensioner or his wife
(or husband)—see sections 24 and 25 of the
In order to avoid danger of overpayment and consequent necessity for a refund by the pensioner, pensioners should notify the Deputy Commissioner of Pensions of any change in their financial circumstances (including those of pensioner’s wife—or husband).
The following are examples of cases which should be brought under notice:—Increase in income, increase in banking account, change of address when pensioner has been living in a home owned by himself or his wife (or husband), receipt of money from sale of houses or land, legacy, insurance, or other source.
Pension Certificate No. | Form 30. |
Post Office Date Stamp to be | |
| |
| |
| |
| |
placed in this square. |
RECEIPT FOR INSTALMENT OF PENSION.
I acknowledge to have received, for the benefit of the pensioner, the sum of £ : :, being fortnightly pension instalment due on in accordance with Pension Certificate numbered as above. I have good reason to believe that the pensioner is alive in Australia, and that the pensioner is not an inmate of any benevolent asylum, hospital, or asylum for the insane. I last saw the pensioner on
Note.—Whenever
payment of a pension instalment is made, the paying officer will hand to the
warrantee a blank form of receipt, which must be brought back on the next
pension pay-day,
The attention of warrantees is drawn to notice on back.
[Back of Form.]
NOTICE.
The amount of a pension is liable
to be affected by changes in the income or property of a pensioner or his wife
(or husband)—see sections 24 and 25 of the
In order to avoid danger of overpayment and consequent necessity for a refund by the pensioner, pensioners should notify the Deputy Commissioner of Pensions of any change in their financial circumstances (including those of pensioner’s wife—or husband).
The following are examples of cases which should be brought under notice:—Increase in income, increase in banking account, change of address when pensioner has been living in a home owned by himself or his wife (or husband), receipt of money from sale of houses or land, legacy, insurance, or other source.
Form 31.
COMMONWEALTH OF AUSTRALIA.
——
The
——
APPLICATION FOR PAYMENT OF FORFEITED INSTALMENT.
Full Name of Pensioner
Full Address
Full Name of other person (if any) authorized to receive payment
Full Address
Pension payable at Certificate No.
To the Registrar of Pensions
at
I being the pensioner or (as the case may be) the person authorized to draw the above-named pension, apply for payment of the forfeited instalment (or instalments) due for the period of fortnights ended 19 , amounting to £
I declare that the particulars given in reply to the following questions are true and correct:—
|
| |
|
| |
Declared at this | Applicant. | |
| ||
| ||
If pensioner
§
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 thefollowing 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 commissioner for declarations, a registrar under the
To the Deputy Commissioner of Pensions,
I have GRANTED waiver of forfeiture of instalments for the period of
I have REFUSED waiver of forfeiture of instalments for the period of
Registrar of Pensions.
Date .
[The Registrar’s attention is particularly directed to Section 40 of the Act and Regulation 29.]
Form 32.
COMMONWEALTH OF AUSTRALIA.
———
The
———
WAIVER OF FORFEITURE.
I hereby grant this warrant, waiving forfeiture of the instalment of the pension which was due to pursuant to Pension Certificate No. on the following payday, viz. but which became forfeited because it was not applied for within twenty-one days of the due date. The instalment may now be paid as though it had not been forfeited. This warrant must be presented to the Postmaster or other paying officer.
Dated at this day of 19
Registrar of Pensions.
Note for Postmaster.—This Warrant must be pinned to the receipt for the instalment concerned.
Form 33.
COMMONWEALTH OF AUSTRALIA.
——
The
——
APPLICATION FOR WARRANT AUTHORIZING PAYMENT TO PERSON OTHER THAN THE PENSIONER.
Note.—A Warrant cannot be issued in respect of any pensioner who is about to leave Australia or who is an inmate, or is about to become an inmate, of a benevolent asylum, hospital, or asylum for the insane.
To the Registrar of Pensions at
I, (
hereby apply for a
warrant under the Act directing that until the warrant is cancelled all
instalments of the pension payable to me at pursuant
to Pension Certificate No. may
be paid to (
Dated at this day of 19
Pensioner’s Signature
(or witnessed mark)
I consent hereto. I am already the holder of warrants for payment of pensions in the following cases, and no others:—
I am *over/*under the age of 21 years.
Signature of Proposed Payee
I hereby certify that the pensioner and the proposed payee are personally known to me, and that owing to the pensioner is now unable, and, in my opinion, will be unable for a period of to collect the pension instalments, and that the proposed payee is a suitable person for the purpose. ‡ §
To the Deputy Commissioner at
I am satisfied that this application should be granted.
Registrar of Pensions
at
Date
(
(
(
* Strike out the word which does not apply.
State how long inability will probably continue.
‡ State title under which certificate is given.
§
This certificate must be signed by one 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 commissioner for declarations, a
registrar under the
Form 34.
COMMONWEALTH OF AUSTRALIA.
——
The
——
WARRANT FOR PAYMENT TO PERSON OTHER THAN PENSIONER.
I direct that until* all instalments of the pension granted to (Certificate No. ) shall be paid to for the benefit of the pensioner
This Warrant, with the Pension Certificate, must be presented to the Postmaster or other paying officer whenever application is made for payment.
Signature of person to whom Warrant granted
* If Warrant granted for an indefiniteperiod, insert here “otherwise ordered by me.”
Form 35.
COMMONWEALTH OF AUSTRALIA.
——
The
——
PENSIONER IN CHARITABLE INSTITUTION.
I report that (Insert name of pensioner.) of (Insert address of pensioner.) who is a pensioner under the above-named Act, was admitted to the (Insert name of Institution.) on the day of 19 , and is still an inmate.
(Pension Certificate No. * Payable at ).
Signature
Office held by person reporting
Date
To the Postmaster or officer paying pensions at
Noted and forwarded to the Deputy Commissioner of Pensions.
The last payment made at this office was for the instalment due on
Signature
Postmaster at
Date
* The number should be filled in if the Pension Certificate has come under the notice of the person reporting.
Form 36.
COMMONWEALTH OF AUSTRALIA.
——
The
——
DISCHARGE OF PENSIONER FROM CHARITABLE INSTITUTION.
I certify that (Insert name and address of Pensioner.) who was admitted to the (Insert name of Institution.) on was discharged therefrom on the day of 19
Signature
Office held by person reporting
Date
To the Postmaster or officer paying pensions at
Note for
Postmaster
For
the purpose of calculating the amount payable to a pensioner on discharge,
Form 37.
COMMONWEALTH OF AUSTRALIA.
——
The
——
AMOUNT PAYABLE ON PENSIONER’S DISCHARGE FROM INSTITUTION.
Note.—In every case where a pensioner has been in a hospital or other charitable institution for more than 28 days, this form must be completed by the postmaster and attached to the receipt for the first payment made to the pensioner after discharge from the institution.
Name Fortnightly rate
Admitted to institution Discharged
| days. | |
|
| days. |
| days*. | |
The following instalments fell due while pensioner was in the institution, and have not been collected, namely:—
Amount
| 19 | £ |
| 19 | |
| 19 | |
| 19 | |
| 19 | |
| £ |
* Deduct amount for period which cannot be paid for, namely:—
days, equal to fortnights and days
Amount payable £
Form 38.
COMMONWEALTH OF AUSTRALIA.
The
| Consecutive Number. |
ALTERATION OF RATE OF PENSION. | |
| |
Advice to Postmaster. |
Pensioner’s name
Pensioner’s address
Certificate No. Payable at
It has been decided to amend this pension from to per fortnight, commencing with the instalment due on
The Postmaster is hereby instructed to pay on and subsequent instalments at the amended rate until further notice.
The Pensioner has been requested to hand you the certificate for amendment. Please make the necessary correction and also note the alteration in your register of payments and on the identification card.
Date
This advice to be retained by Postmaster for at least six months.
| Consecutive Number. |
| |
| |
I have altered the register of payments, the identification card, and the pension certificate in accordance with the advice numbered as above.
Post Office Date Stamp.
This acknowledgment, which should be completed by the Postmaster immediately after the above alterations have been made, should be detached and forwarded to the Deputy Commissioner.
Form 39.
COMMONWEALTH OF AUSTRALIA.
——
The
| Consecutive Number. |
| |
|
To
Certificate No. Payable at
It has been decided to amend your pension from to per fortnight, commencing with the instalment due on
The Postmaster has been instructed to pay on and subsequent instalments at the amended rate until further notice.
In order to prevent any delay in payment, please hand your certificate as soon as possible to the Postmaster.
Reasons for alteration
If Invalid or Old-age pension is reduced, calculation should be shown.
Date
Form 40.
COMMONWEALTH OF AUSTRALIA.
——
The
——
NOTICE OF DEATH.
To the Deputy Commissioner of Pensions at
I advise that I have received notice of the death of who died on the day of 19 aged years, and I believe *him/*her to have been a pensioner under the above-named Act whose pension was paid at
Registrar of Deaths.
Address of the Official making this report
* Strike out what is inapplicable.
Date 19
Regulations under the
Printed and Published for the Government of the Commonwealth of Australia by H. J. Green, Government Printer for the State of Victoria.
0
0
0