APPLICATION FOR REVISION OF PENSION UNDER GO 271 / GO 579
FROM RECENTLY TAKEN PASSPORT SIZE
PHOTO/JOINT PHOTO TO BE AFFIXED
WITH SIGNATURE AT THE BOTTOM
TO
THE PENSION PAY OFFICER,
DPI COMPLEX,
COLLEGE ROAD,
CHENNAI 6
1.Name of the Pensioner/Family Pensioner
(in Block letters)
2.Pension Payment Order No
(Xerox copy of the pension payment order
should be enclosed)
3.Date of retirement
4.Designation/Office/Department
from which retired
5.Postal address (Present address)
6.Amount of original pension at the
time of retirement
7.Revised pension (if any)
(i) As on 31/05/88:
(ii) As on 01/04/99 as per GO 200
(iii)As per G O 449
8.Pilot scheme /Psb scheme
9.Pension drawing bank and Branch
with account number:
DECLARATION
Certified that if any amount of pension arrears as per G O 579, Finance
(Pension) Department,dated 15/9/2006 paid to me afterwards found to be excess of
that to which I am entitled to by Auditing Authority later under the re-fixation
such amount found in excess will be refunded by deduction from Pension / Family
pension
Signature of the Pensioner.
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