Placed below is a copy of the Life Certificate which may be used after a bit of formatting. It is for the State bank Of India and must be suitably altered if it is not your Bank. Adding your photograph/joint photograph will update the records of your likeness with the Bank. It is an option and may be exercised. People living abroad may get the counter signatures from the Branch Head of the Indian Bank in that region. Alternatively, the Air Attache/Defence attaches/Consuls, at Indian missions abroad can also be approached. Dispatch to India is possible through the diplomatic bag, These certificates have to be dated in November and must reach the Branch of the Pension Disbursing Bank early November. Some Banks do not mind, if these are dated in October also. Please check with your own Pension Disbursing Branch. CPPC S L NO CATEGORY............................................................................................................../NO................................. CERTIFICATE TO BE SUBMITTED BY THE PENSIONER1. LIFE CERTIFICATE Certified that I have seen the Pensioner Shri ........................................................................................... holder of PPONo …………………………………………………………………………… and that he is alive on this date. ……………………………………………….. ……………………………………………………… SIGNATURE OF THE PENSIONER Address : - ……………………………… .. ……………………… . Name: ………………………………………………………………………… .. …………………………………………………………………… S.S. No. (If State Bank Officer) 2. NON-EMPLOYMENT/RE-EMPLOYMENT CERTIFICATE I. I declare that I have not taken any employment in any capacity either in GovernmentDepartment/Office/Company/Corporation/Autonomous Body or Society of Central or State Government ora Local Fund during the year ending 30th November 20 ………… . ORII I declare that I have not accepted any commercial appointment in or outside India. ORIII. I declare that I have not accepted any employment under the Government outside India/an InternationalOrganisation of which the Government of India is not a member. ANDI undertake to inform the Bank promptly on accepting any employment ORIV. I declare that I have accepted Commercial employment in India after obtaining provisional sanction of theconcerned. Government and none of the conditions, if any, attached therein by the Government has beenviolated and I am drawing salary as mentioned in para-VI, ORV. I declare that I have taken employment in..........................................as...................................and I am drawingsalary as mentioned in para - VIVI. Basic pay..............................................Special pay........................................DA..........................Otherallowances.......................................................Total S & A.....................................................................OR Honorarium........................................................I declare that I am not getting any increment or allowance on account of my previous employment in whichI am drawing this pension.I further declare that the order of my employment or the pension rule governing the pension which I amdrawing to, do not stipulate my pension in full or any part component being held in abeyance during theemployment period. 4. UNDERTAKING I. I undertake to self-assess, pay income Tax and file the income Tax Return in respect of my pension, if requiredand inform the Bank.II. I hereby undertake to refund any excess payment credited to my account due to delay in receipt or anyinformation or any bonafide error pertaining to payment of my monthly pension and authorise Bank torecover such excess payment from my account and/or the pension payable to me.III. I certify to the best of my knowledge and belief that the above declarations are correct.Signature of the Authorised Officer verified Signature/L.T.I. of the pensioner verification. Icertify to the best of knowledge and belief that the above declaration is correct. Forwardedto CPCC, Bhubaneswar for necessary action. Signatures Of The Pensioner NAME OF THE BRANCH FOR USE AT THE BRANCH ....................................................... SIGNATURE OF THE PENSION PAYING OFFICER/ ..................................... , CODE - ACCOUNTANT/BRANCH MANAGER (With Seal) NAME: …………………………………………….SS No..................
Posted on: Tue, 14 Oct 2014 02:17:57 +0000
Trending Topics
Recently Viewed Topics
© 2015