Western Australian Current Regulations

WAR SERVICE LAND SETTLEMENT SCHEME REGULATIONS 1954 - FIRST SCHEDULE

War Service Land Settlement

Western Australia

APPLICATION FOR CLASSIFICATION

I, (a) ....................................................., being a (b) ..............................................
................................................., hereby apply for classification under the War Service Land Settlement Scheme Act 1954 .

In support of this application I furnish the particulars as set forth on the back hereof.

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(Signature)

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(Postal Address)

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(Road Board District)

Date .....................................................

(a)         Name in full.

(b)         State whether “member of the forces” or “discharged member of the forces”. See footnote.

To the Chairman,
Land Settlement Board, Perth:

For Office Use Only
Decision of Classification Committee

Received ........................................

Entered ...........................................

Notice to attend ..............................

Date of inquiry ...............................

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Note. — See Regulations 6 and 7 for “Member of the Forces” and “Discharged Member of the Forces”.

Questionnaire

Question	Answer
1.         Date of birth?
2.         To which of the forces (naval, military or air) do you, or did you, belong?
3.         What is, or was —             (a)         Your identification number?             (b)         Your regimental number?             (c)         Your unit?	.......................... .......................... ..........................
4.         If you are a discharged member of the forces of the present war, what was —             (a)         Your length of service?             (b)         The date of your discharge?             (c)         The reason for your discharge?	.......................... .......................... ..........................
5.         What physical disabilities (if any) do you suffer from by reason of wounds or disease resulting from your naval, military or air force service?         State particulars as to loss of limb or faculty, or as to condition of health.
6.         Are you in receipt of a pension in respect to your war service? If so, state percentage of disability.
7.         What form of farming or grazing do you desire to follow, and in what district?
8.         What experience have you had (if any) in farming or pastoral pursuits? State where, quote the period and class of farming, etc., engaged in, and the name of your employer when you joined the forces.
9.         What is the amount of capital at your disposal?
10.         Are you to be financially assisted by your parents or any person? If so, to what extent?
11.         Are you single, married, or a widower, if married, or a widower, state number of children dependent on you.
12.         What land (if any) do you at present own or have an interest in? State particulars.
13.         If married, what land or interest in land (if any) does your wife own? State particulars.
14.         Should it become necessary for you to be interviewed in connection with this application, and you are in Western Australia, at what centre would you prefer such interview to take place?

Date ........................................................

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(Signature of