||Name of the applicant in block
letters and full postal address.
||Type of pension admissible.
||Name of the Pensioner/ deceased
Government servant (Pensioner) in case of family pension.
||Date of retirement /death of the
||Date from which pension/family
pension is being drawn.
||Pension Payment Order (P.P.O) No.
||Office/ Department/Ministry in
which the pensioner/ deceased government servant (pensioner) served last and the post held
||The scale of pay of the post last
held and the last pay drawn.
||Consolidated final pension /
family pension admissible from 1.1.96.
||Name of the authority which issued
||Name of the Pension Disbursing
Authority with SBA number, wherever applicable.
||If any documentary evidence is
being attached to facilitate settlement of the case, details thereof.