AFVOA Newletters of Year 2010

Page 20 of 50 (iv) Date of retirement/discharge (v) Name of Rec Off (PBOR) (vi) Original PC/PPO No. & year (In case of pension circular quote pension circular No., part and descriptive SI No.) (vii) Particulars of Pension Discharge Authority (a) Station (b) Treasury/DDPO/PQAO/Bank/Post Office (c) Branch with full address and SB A/C No. (viii) Particulars of pay last drawn at the time of retirement (ix) Family pension from other sources:- (a) Whether a family pension is already sanctioned by any other pension sanctioning authority and if so the name of the pension sanctioning authority, PPO No and the particulars of the pension disbursing authority. (b) Whether Family is eligible for family pension from any other source and if so, the authority who will sanction the pension. (c) In case the family is sanctioned pension or is eligible for family pension from any other source, an option to receive family pension for the spell of service for which the pension bas been sanctioned vide PPO/PC No. quoted above, foregoing family pension admissible from any other source should be enclosed. (x) Details of family, in terms of pension rules, eligible for family pension: - SI No. Names(s) and addresses of members Relation ship with the pensioner Date of marriage Marital status (in case of daughters Date of birth (xi) Attested joint photographs of Smt --------------- ----------------------- is pasted above (Attestation can be done by any Gazetted Officer, pension Disbursing Officer, Head of office of retired official, village Sarpanch, Block Development Officer. MLA / MLC etc.) (xii) Signature of or thumb impression of spouse (xiii) Mark of identification Signature of or left hand thumb impression of the Pensioner (in case of female right hand thumb) Witness: Name Full address Signature 1. 2.