|
Form of Application for Commutation of
Pension
(Refer Rule 3 of Commutation of Pension)
|
|
I
______________________ desire
to commute portion of my Original / reduced pension of |
|
|
Rs_______
P __per month. I certified that I have correctly answered each and all of
the |
|
|
question below. My pension
payment order.no. is ___________ and my pension is now being |
|
drawn from _____________
Treasury. |
|
|
|
|
|
|
Place |
|
|
|
|
|
Signature |
|
|
|
Date |
|
|
|
|
|
Designation |
|
|
|
|
|
|
|
|
Address |
|
|
|
|
|
|
|
|
|
|
|
|
|
Here
enter the class of pension, superannuation, Retiring, invalid or
compensation. The word |
|
" Original " or
'reduced' should be scored out according as the circumstance require. |
|
|
|
|
|
Question |
|
|
Answers |
|
|
|
1. What is the date of your birth
? |
|
|
|
|
|
|
2. How much of your pension do
you wish to commute. |
|
|
|
|
3. Do you suffer from any
complaint likely to shorten Life ?
If so, state its nature. |
|
|
|
|
4. Name the members of your
family dependant on you
with their respective sex and ages. |
|
|
|
|
5. What is the date of your
retirement? |
|
|
|
|
|
|
6.
Whether any portion of your pension has already
been commuted and whether any previous applications
made by you was rejected on medical grounds ? |
|
|
|
|
|
7. State the amount of Provident
Fund money and the
amount of death-cum-retirement gratuity received by
you. |
|
|
|
|
|
8.
Name of the Accounts Officer who authorised the |
|
|
|
|
|
payment of Provident Fund money and death-cum- |
|
|
|
|
|
retirement gratuity to you. |
|
|
|
|
|
|
|
9.
Nature of sanction |
|
|
|
|
|
|
|
10.Name of Pension sanctioning
Authority |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Place :________________ |
|
|
|
Signature: |
|
|
|
Date :_________________ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Endorsement
of the Pension Disbursing Officer |
|
|
|
|
|
Forwarded to the Secretary to Government, Finance ( Pension )
department / |
|
|
|
Pension Sanctioning Authority through the Accountant General. The
Pension |
|
|
|
is chargeable to ________________________________ |
|
|
|
|
The amount and class of pension and the date of birth of the
pensioner |
|
|
|
have been verfied from the
disburser's half of the Pension Payment Order. |
|
|
|
I have verfied from the Pension Payment Register that no portion of
his |
|
|
|
pension was previously commuted /
Rs._________ out of the original pension |
|
|
|
of Rs.___________ was commuted
for Rs. ___________ on _____________ |
|
|
|
With effect from ______________________ |
|
|
|
|
|
The identification marks of pensioner or given below |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Place :____________________ |
|
|
|
Pension
Disbursing Offier |
|
Date :___________________ |
|
|
|
Designation |
|
|
|
|
|
|
|
|
|
|
|
|
Certificate
of the Pension Sanctioning Authority whether disciplinary proceedings
against the |
|
applicant
are pending or not( Rule 6 ) of commutation rules |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Pension Sanctioning Authority |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Designation |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
To |
|
|
|
|
|
|
|
|
|
The Accountant General Tamilnadu |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
No.P.Com |
|
|
|
Office of the Accountant General |
|
|
|
|
|
|
|
Chennai - 600 018 |
|
|
|
|
|
|
|
|
Dated :- |
|
|
|
|
Forwarded : |
|
|
|
|
|
|
|
|
1. No portion of the
pension has been previously commuted. |
|
|
|
|
2. No application for
commutation was rejected on medical grounds. |
|
|
|
3. Previous application
for commutation was rejected on medical |
|
|
|
|
grounds
in G.O.No______________ |
|
|
|
|
|
|
4. Rs.________ out of
original pension of Rs___________ was previously commuted |
|
|
in
G.O.No_____________________ |
|
|
|
|
|
5. Pension sanctioned
in G.O.No. |
|
|
|
|
|
|
6. The pension is final
/ anticipatory. |
|
|
|
|
|
|
7. Other remarks, if
any |
|
|
|
|
|
|
|
|
|
|
|
|
Assistant
Accounts Officer |
|
|
To |
|
|
|
|
|
|
|
|
|
The Secreatary to Government of
Tamilnadu |
|
|
|
|
