Scribd Logo
Încărcați

Bine ați venit la Scribd!

  • Annual pension verification form

    Încărcat de

    Anupoju Appalaraju
    318 vizualizări4 pagini
    This document is an annual verification certificate for Smt. Karri Amaravathi, who receives a service pension. It provides her personal details like name, date of birth, PPO number, bank account information. It also includes a declaration signed by her stating she is not receiving any other pension benefits. The certificate is signed by the treasury officer, pension disbursing officer, and gazetted officer/bank manager to verify she appeared in person and is still alive.

    Descriere originală:

    Titlu original

    pension verification

    Drepturi de autor

    © Attribution Non-Commercial (BY-NC)

    Formate disponibile

    XLSX, PDF, TXT sau citiți online pe Scribd

    Vi se pare util acest document?

    Este necorespunzător acest conținut?

    Raportați acest document
    This document is an annual verification certificate for Smt. Karri Amaravathi, who receives a service pension. It provides her personal details like name, date of birth, PPO number, bank account information. It also includes a declaration signed by her stating she is not receiving any other pension benefits. The certificate is signed by the treasury officer, pension disbursing officer, and gazetted officer/bank manager to verify she appeared in person and is still alive.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca XLSX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    318 vizualizări4 pagini

    Annual pension verification form

    Încărcat de

    Anupoju Appalaraju
    This document is an annual verification certificate for Smt. Karri Amaravathi, who receives a service pension. It provides her personal details like name, date of birth, PPO number, bank account information. It also includes a declaration signed by her stating she is not receiving any other pension benefits. The certificate is signed by the treasury officer, pension disbursing officer, and gazetted officer/bank manager to verify she appeared in person and is still alive.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca XLSX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 4

    ANNUAL VERIFICATION CERTIFICATE

    (GOVT.MEMO NO.28407-A/239/PSC/07,DT:4/1/2008)
    1 Type of Pension Service Pension / Family
    Pension
    2 Name of Individua Smt.KARRI AMARAVATHI
    S/o.D/o.W/o.H/o W/o KARRI VEERACHARYULU
    3 Date of Birth / Age 15-01-1963 47 years Photo attested by Bank Manager/
    4 P.P.O. No 22- FG -003840 Gazetted Officer

    5 Name of Bank and Branch SBI, Dondaparthy, Visakhapatnam


    6 Bank Account No Old New

    10667624121
    -
    --
    7 Employment Particulars
    (Applicable if Re-Employed after retirement /
    - -
    --
    Appointed on Compassionate Grounds)

    --
    le
    a) Name of Office

    ab
    b) Date of Employment/
    Re-Employment
    c) What is the D.A being drawn on lic
    pp
    employment
    d) Date from which D.A is Drawn
    A
    ot
    8 Re-marriage Particulars if any
    a) Date of Re-marriage
    N
    __
    b) Name of the spouse

    __
    9 Present Residential address with
    Phone No.
    10 Pan No. if any __
    DECLARATION OF THE PENSIONER
    I hereby declare that:
    i. I am not drawing any other pension
    ii. I am drawing other pension through PPO No
    iii. I am not drawing any D.R on that pension
    iv. The particulars mentioned above are true to the best of my knowledge and belief.
    v. If the above particulars proved wrong at any time, I am liable for disciplinary / criminal action as per rules

    Left hand Thumb


    Impression of the Pensioner
    (Signature of the Pensioner)
    Date:
    Place:
    CERTIFICATE-1
    (To be issued by the Drawing & Disbursing Officer)

    Certified That Smt./Sri.___________. W/o._________ was appointed as ___________ on Compassionate Grounds on this office
    with effect from_____ She/He is being paid the Dearness Allowance eligible to her at the rates sanctioned by the government from time
    to time.

    As per the declaration filed by the individual, she / he is not drwaing any D.R on the family pension being drawn vide PPO
    No._________ from the Sub-Treasury / Pension pPayment Office.

    Station:
    Date: Signature & Office Seal

    CERTIFICATE-II
    Certified That I have seen the pensioner as on November 2010 and he/she is alive

    Signature of the Treasury Officer Signature of the Gazetted Officer/


    i.e. STO/ATO/APPO (With name and seal)
    Bank Manager / Notary
    (With name & Seal)
    NOTE:
    i The Pension Disbursing Officer can sign the Certificate if the pensioner appears personally before the Pension Disbursing Officer.

    ii. If pensioner does not appear personally before the Pension Disbursing Officer, the Certificate shall be signed by any Gazetted
    Officer / Bank Manager.
    iii. The Annual Verification Certificate are obtained from 1st November on wards.
    iv. The Non-receipt of the Annual Verification Certificate the pension shall be stopped from 1st April on wards (i.e) March payable on
    1st April.
    ACKNOWLEDGEMENT
    Received the annual Verification Certificate date: Nov.2010 of Sri./ Smt. Karri Amaravathi Holder of PPO No 22-FG-003840

    Receiver Signature , Date & Stamp.


    CATION CERTIFICATE
    07-A/239/PSC/07,DT:4/1/2008)

    -
    - --
    -
    --
    --
    le
    cab
    li
    pp
    A
    ot
    N
    __
    _ __
    _

    S-ar putea să vă placă și