|
| As
referred to in Para II of OM No 45/86/97-P&PW(A)-Part-III dt.10th February, 1998. |
|
|
| FORM
OF APPLICATION |
| To,
---------------------------------
---------------------------------
---------------------------------
(PENSION SANCTIONING AUTHORITY) |
|
|
| Subject: Revision of Pension/family pension in the case of
pre-1986 pensioners/family pensioners as on 1.1.1996 in terms of Department of Pension
& Pensioners' Welfare OM. No.45/86/97- P&PW(A)-Part-III dated 10th February, 1998. |
| Sir,
Kindly revise my
pension/family pension entitlement shown in my PPO (Photo copy enclosed) in terms of the
Department of Pension & Pensioners' Welfare Office Memorandum
No.45/86/97-P&PW(A)-Part-III dated 10th February, 1998. The requisite particulars are
given below:- |
| 1. |
Name of the Applicant in Block
letters and Full Postal Address |
| 2. |
Type of pension admissible |
| 3. |
Name of the deceased
Government servant/pensioner in case of family pension.* |
| 4. |
Date of retirement/death of the
Government employee. |
| 5. |
Date from which pension/family
pension is being drawn. |
| 6. |
Pension Payment Order (PPO) No. |
| 7. |
Office/Department/Ministry in
which the pensioner/deceased government servant(Pensioner) served last and the post held
by him. |
| 8. |
The scale of pay of the post last
held and the last pay drawn. |
| 9. |
Name of the Pension Sanctioning
Authority i.e. the authority which issued PPO. |
| 10. |
If any documentary evidence is
being attached to facilitate determination of length of qualifying service as also revised
scale of pay for the post last held by the pensioners/deceased Government servant or
pensioner. If yes, details thereof. |
|
|
|
|
|
Date: |
|
(SIGNATURE
OF PENSIONER/FAMILY PENSIONER) |
|
|
|
Particulars at 2,3,5 and 6
verified |
|
SIGNATURE
Rubber Stamp of
Pension Sanctioning Authority |
|
*Applicable only in cases where the applicant is a
family pensioner. |
