IMPORTANT NOTICE FOR RAILWAY PENSIONERS
Railways are revising the Pension Payment Order of all Pre-2006 pensioners/family pensioners in terms of the Sixth Pay Commission rules. Revision of all PPOs is compulsory even if pension/family pension is ready being drawn at revised rates. Unrevised PPOs do not have new rules of admissibility. Hence, pensioners may have problems in drawing pension/family pension in future like benefit of age based enhanced pension/family pension, new categories of beneficiaries in family pension etc. All the Railway pensioners who have not got their PPOs revised as yet may immediately fill up the form below and submit to the Personnel Department of the unit from which they retired.
APPLICATION FORM FOR REVISION OF PPO
1. Name of the Applicant (In block letters) : …………………………………………
2. Full Postal Address : ………………………………………….
………………………………………….
3. Name of the Railway Pensioner & Designation : ………………………………………….
4. Date of Retirement/death of Railway Servant : ………………………………………….
5.a) Name of the spouse & DOB (with proof) : ………………………………………….
5.b) Name of dependent & DOB (with proof) : ………………………………………….
5.c) Relation with deceased Pensioner : ………………………………………….
(i) Unmarried Daughter : ………………………………………….
(ii) Widow/Divorce daughter : ………………………………………….
(iii) Handicapped son/daughter : ………………………………………….
(iv) Wholly dependent parents : ………………………………………….
(v) Disabled Siblings : ………………………………………….
(vi) Any other : ………………………………………….
6. Date from which Pension/Family Pension is
drawn : ………………………………………….
7. PPO No. : ………………………………………….
8. Pay Scale & Last Pay : ………………………………………….
9. Name of the authority which Issued PPO
(Copy enclosed) : ………………………………………….
10. Name of the Bank & address A/c No. : ………………………………………….
11. Documents required :-
a) Copy of PPO at the time of retirement.
b) Revised PPO as on 01/01/96
c) Proof of date of birth of spouse
Signature
(Pensioners/Family Pensioner/Dependent)
Place:……………………
Date:…………………….
Annexure D
Address :______Telephone ______
______Saving Bank A/c No.______
Date of Retirement______
NON-EMPLOYMENT/ RE-EMPLOYMENT CERTIFICATE
I declare that I have not received any remuneration for serving in any capacity in an establishment of the Central Government /State Government/Public Undertaking or from a local fund during the period November______to October______
I declare that I have been employed/re-employed in the office of the ______
______and was in receipt of the following employment during the period ______(to be specified)
I declare that I have accepted commercial employment after obtaining/without obtaining sanction of the Govt. (to be furnished by Central Service Class-I Officer within the first year from the date of retirement).
I declare that I have/ have not accepted any employment under any Govt. outside India after obtaining/ without obtaining sanction of the Govt. ( to be furnished by Central Service Class-I Officer only)
(Delete whichever is not applicable)
Place______Signature______
Date______Name of Pensioner______
P.P.O. No.______
LIFE CERTIFICATE
Certified that I have seen the pensioner Shri/Smt………………………………………who is Physically handicapped son/daughter, minor son, unmarried/divorce/widowed daughter, child born after retirement, post retirement spouse, wholly dependent parent, disabled sibling, any other category (may be specified) of Shri/Smt………………………Original Pension Holder of the PPO No………………………..and that he/she is alive on this date.
(Tick the correct)
Signature of Pensioner……………………. Signature ……………......
Place……………………………………. Name of Pensioner……. ……………
Designation……………………...
Authorized Officer………………
CERTIFICATE OF NON-MARRIAGE/NON RE-MARRIAGE
I hereby declared that I am not married/I have not been married during the past six months. In case of my remarriage the Bank immediately may stop disbursing the pension.
______
Place: ……………. Signature ………………………
Date……………… Name of Pensioner …………………….
P.P.O.No……………………………….
I certify to the best of my knowledge and belief that the above declaration is correct.
Signature of a Responsible
Officer or a well-Known person
Name______
Designation______
Place: ______
jsy isa’ku Hkksfx;ksa ds fy, egRoiw.kZ lwpuk
jsyos 2006 ls iwoZ tkjh gq, isa’ku Hkqxrku vkns’kksa ¼ihihvks½ dks NBs osru vk;ksx ds fu;eksa ds vuqlkj la’kksf/kr dj jgk gS A lHkh ih0ih0vks0 dk la’kks/ku vfuok;Z gS] pkgs isa’ku la’kksf/kr njksa ij fey jgh gks A vla’kksf/kr ih0ih0vks0 esa u, fu;eksa ds vUrxZr ns; isa’ku tSls fd vk;q ds vk/kkj ij c<us okyh vfrfjDr isa’ku@ikfjokfjd isa’ku dh ubZ Jsf.k;kW bR;kfn ykHkksssa dk izko/kku ugha gS A blls mUgsa Hkfo"; esa feyus okyh isa’ku@ikfjokfjd isa’ku esa leL;k gks ldrh gS A
lHkh iwoksZRrj jsyos ds isa’ku Hkksxh ftUgksus vius ihihvks esa la’kks/ku ugha djk;k gS os rRdky uhps fn, x;s izi= dks Hkjdj vius lsok fuo`Rr dk;kZy; ds dkfeZd foHkkx esa tek djk, A
isa'ku vnkyr vkns’k ds la’kks/ku gsrq vkosnu izi=
1- vkosnu drkZ dk uke ¼Li"V 'kCnksa esa½ ------
2- ?kj dk irk ------
3- jssy isa’kuHkksxh dk uke ------
4- jsy deZpkjh dk lsokfuo`fRr@e`R;q frfFk ------
5- d½iRuh dk uke rFkk tUefrfFk ¼izek.k lfgr½ ------
[k½ vkfJr dk uke ,oa tUefrfFk¼izek.k lfgr½ ------
x½ e`rd isa’kuHkksxh ds lkFk laca/k ------
i½ vfookfgr iq=h % ------
ii½ fo/kok@rykd 'kqnk iq=h ------
iii½ fodykax iq=@iq=h ------
vi½ iw.kZ :Ik ls vkfJr ekrk&firk ------
v½ fodykax HkkbZ] cgu ------
vi½ vU; Js.kh ------
6- isa’ku@ikfjokfjd isa’ku izkIr djus dh frfFk ------
7- isa’ku Hkqxrku vkns’k la[;k ¼ihihvks ua0½ ------
8- osru nj ,oa vfUre osru ------
9- isa’ku Hkqxrku vkns’k tkjh djus okys izkf/kdkjh dk uke ¼izfrfyfi layXu½------
10- cSad dk uke ,oa irk] isa’kuj [kkrk la[;k ------
11- visf{kr nLrkost ------
d½ lsokfuo`fRr ds le; tkjh ihihvks dh izfrfyfi
[k½ fnuakd 01-01-1996 dk la’kksf/kr ihihvks
x½ iRuh@ifr dh tUefrfFk ¼izek.k lfgr½
gLrk{kj
LFkku------isa’ku Hkksxh@ikfjokfjd isa’ku Hkksxh@vkfJr fnuakd ------