Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
PERSONAL DETAILS
Name of the Government Employee
Father's/Husband's Name
D.D.O. Designation
Designation
Superintendent
D.D.O. Place of wo
Place of working
Nampally
Hyderabad
Name of Pension D
Date of Birth
November
11
1953
2
Employee Name of
13
13
March
3
1990
39
Date of Retirement
25
25
November
11
2011
60
Permanent Address
Relationship with th
H. No. 13-11-245/A/16/2/B, Tallagadda,
Karwan, Hyderabad. PIN-500055
07-11-2012
Hyderabad
Amount of Share P
Applicat
Part II
SALARY DETAILS
PAY PARTICULARS
Part II
DEDUCTIONS
Scale of Pay
17
14860-39540
A.P.G.L.I.S.
Basic Pay
18
10900
G.I.S.
2
30
5
150
Developed B
200
K. Sreenivas
District.
1. If any mis
rectify the
ksr_0708@ya
3. Fill the dat
4. Verify with
Spl. Pay/P.P
125
Proffessional Tax
D.A. Percentage
24.824
Others if any
HRA Percentage
20
3
Additional HRA
Applicable
1
C.C.A.
130
4
S.C.A.
160
6
Others if any
450
Annexu
500
Sl No.
1
Date of Birth
15-07-1978
Relationship wit
Employee
Son
D.D.O. Designation
Saidabad
Hyderabad
P.A.O., Hyderabad
102356789145
NOMINEE DETAILS
Name of the Nominee
Smt. R. Lingavathy
Wife
55
Full Amount
Years
Annexure II
No Dues
Part II A
Annexure III
Letter to AG
Part II B
L.P.C.
DDO Procs
Annexure I
Appendix
Iden Marks
Developed By:
K. Sreenivas Reddy working at O/o the District Educational Officer, Hyderabad
District.
1. If any mistakes found in this software please give your valuable suggestions to
rectify the mistakes. Send your valuable suggestions to the Mail Id:
ksr_0708@yahoo.co.in.
3. Fill the data in pink coloured cells only.
4. Verify with experts before the submission of your bills.
Relationship with
Employee
Son
Married/ Unmarried
Married
(The Pension Sanctioning Authority shall forward the application duly processing to the AG (A&E) / L.F. Authority wi
(As per Govt. Circular Memo No. 13910/90/A1/PSC/04 Fin (PSC) Dept., dt: 21-06-2004)
2.
b) Post held
Superintendent
3. Permanent Address
5. Commutation of Pension
a) Whether willing to commute 40% of monthly
pension,
subject
to
A.P.
Civil
Pensions
(Commutation) Rules, 1944
If the answer is NO, specify the fraction less than
b) 40% (As per G.O.Ms.No. 158, dt: 16-09-1999)
YES/
NO
P.A.O., Hyderabad
S.B. Accoun
102356789145
(b)
(d)
Sl
No.
Date of Birth
Relationship
with Govt.
Servant
Married or Unmarried.
Date of marriage if
married
Sri. R. Ramana
15-07-1978
Son
Married
Whether Em
Give details
Yes, Jun
Instructions:
1.
The Government Servant is instructed to fillup the proforma very carefully as the data furnished is vital for sanction of family
may note that, alterations of the data furnished at a later date is not pemissible.
2.
The family for the purpose mean "wife" or "husband" as the case may be, "sons" and "unmarried daughters" as laid down in
family pension) and Rule 46(5) (for gratuity) of A.P. Revised Pension Rules, 1980.
3.
In case of death while in service of Government Servant, the answer "Married" in case of daughter will be understood tha
already married as on the date of death of the Government Servant.
DECLARATION
1.
I undertake to refund the amount of Pension, Gratuity and Commutation, if it is found subsequenty to be in excess of the a
was entitled under the rules.
2.
I solemnly affirm that, the particulars given by men in Part-I at item 7 are correct and true to the best of my knowledge
future, I am liable for suitable action as may be taken by the Government.
3.
The particulars given above are correct and true to be best of my knowledge. If found false in future I may be liable for any a
taken by the Government.
Place:
07-11-2012
Date:
Hyderabad
2. Certified that the person/persons mentioned by the Government Servant / Applicant in item 7 of Pa
entitled to receive the Pension/ share of Gratuity
3. Guardianship Certificate (To be filled in whereever necessary)
This is to certify that, the following minors of the deceased Government Servant L
____________________________ is/are under the guardianship of Sri./Smt. __________________
Sl. No.
Name
Date of Birth
Place:
Date:
07-11-2012
Hyderabad
Office Seal
PART - I
rnished by Government Servant / Applicant
P.A.O., Hyderabad
102356789145
orma very carefully as the data furnished is vital for sanction of family pension. He/she
er date is not pemissible.
as the case may be, "sons" and "unmarried daughters" as laid down in Rule 50(12) (for
vised Pension Rules, 1980.
ant, the answer "Married" in case of daughter will be understood that the daughter is
ment Servant.
DECLARATION
and Commutation, if it is found subsequenty to be in excess of the amount to which I
n Part-I at item 7 are correct and true to the best of my knowledge. If found false in
y the Government.
best of my knowledge. If found false in future I may be liable for any action that may be
2.
3.
------
4.
08-11-1953
5.
13-03-1990
6.
25-11-2011
7.
Superintendent,
8.
YES / NO
YES / NO
------
9.
TOTAL SERVICE (6 - 5)
10.
NIL
b) Suspension Period
NIL
c) Dies - Non
NIL
d) Boy Service
NIL
NIL
NIL
11.
12.
Weightage, if any
5 Years
13.
14.
15.
16.
Rs. 14860-39540
Rs. 10900
= Rs. 4377 /-
B.P: Rs. 10900/- X D.A. @ 24.824% = Rs. 2706/(Rs.10900+Rs.2706) X 53 X 1/4 = Rs. 180280/-
17.
18.
19.
a)
N.A.
b)
N.A.
a)
Service Pension
#VALUE!
b)
N.A.
c)
N.A.
Principal
Interest
To
TOTAL
Note:
20.
Information with conditions will not be accepted by Pension Issuing Authority. Amounts for recovery should be
and should be in whole rupees. Absence of information will be understood as no dues for recovery.
L.P.C. Enclosed
YES / NO
YES / NO
-----21 Years - 8 Months - 14 Days
NIL
NIL
NIL
NIL
NIL
NIL
Rs. 4377 /-
B.P: Rs. 10900/- X D.A. @ 24.824% = Rs. 2706/(Rs.10900+Rs.2706) X 53 X 1/4 = Rs. 180280/As applicable to the case under consideration
N.A.
N.A.
As applicable to the case under consideration
#VALUE!
N.A.
N.A.
Total
L.P.C. Enclosed
PART - II (B)
SANCTION OF PENSION
I am declared by the Head of the Department to be the Head of the Office to accord sanction in
under the powers delegated vide G.O.Ms. No. 262, Finance & Planning (FW-PSC) Department,
1998.
ii)
I am the next Gazetted Authority in the heirarchy to the Head of Office in this case who is a Non
Officer and hence, I am competent to accord sanction under the powers delegated vide G.O. Ms
Finance & Planning (FW-PSC) Department , dated: 23-11-1998.
Pensionary benefits including commutation found admissible under the rules may be authorized. It is v
records in my custody and certify that no disciplinary or judicial proceedings are pending / contemplat
retiring / retired Government Servant to whom I am the authority for sanction of pension.
i)
Service Pension
Rs. 4377 /-
ii)
Retiring Gratuity
iii)
Commutation
#VALUE!
Rs. 00-00 /-
Rs. 00-00 /-
Office Seal:
Date:
Note 1:
This is to be prepared in duplicate by the Pension Sanctioning Authority, one for the record
Sanctioning Authority and the other one to be sent to the Accountant General / Local F
Officer.
Note 2:
The Pension Sanctioning Authority should satisfy about the correcness of the particulars
furnished by the Government Servant/Applicant in Part-I.
Note 3:
If the pensionary benefits are not to be released, Part - II (B) shall be struck off.
Note 4:
If there is any likelihood of delay, Anticipatory Pension / Anticipatory Gratuity as per Rule
Revised Pension Rules, 1980 shall be drawn and paid by the Head of Office to the beneficia
any delay.
Note 5:
Heads of Departments are those listed in Appendix-I mentioned in Article 6 of A.P. Fina
Volume-I / Subsidary Rule 32 (ii) of F.R. 9.
PART - II (B)
CTION OF PENSION
Rs. 4377 /-
#VALUE!
Rs. 00-00 /-
Rs. 00-00 /-
ANNEXURE - I
DESCRIPTIVE ROLLS
A. SPACE FOR PHOTOGRAPHS :
Single Photo
Joint Photo
(Attestation has to be done across the photoes by a Gazetted Officer of A.P. Government Service)
Service Pensioner:
2.
D. LEFT HAND THUMB AND FINGER IMPRESSION OF SERVICE PENSIONER / FAMILY PENSIONER / GR
GUARDIAN OF MINOR OR HANDICAPPED CHILD :
(to be given by illeterate or those unable to sign and for others it is optional)
Details
Thumb Finger
Fore Finger
Middle Finger
Ring Finger
Service Pensioner
Family Pensioner
Gratuitant
Guardian of Minor/
Handicapped Child
Place:
07-11-2012
Date:
Hyderabad
Office Seal:
Attested By
Signature:
Name:
Designation:
Note:
(3) Copies will be forwarded to Accountant General / Local Fund Audit Officer by Pension
Authority and one will be retained by the Pension Sanctioning Authority.
ANNEXURE - I
DESCRIPTIVE ROLLS
Joint Photo
AM
e.
Little Finger
Attested By
Signature:
ANNEXURE - II
NOMINATION
(The Government Servant may use separate forms, if he wishes to make different nominations for each type of payment, men
I here by nominate the person / persons mentioned below and confer on him /her /them the right to receive Life Time
Retirement Gratuity that may be sanctioned by Government, in the event of my death while in service and right to recieve on m
Arrears of Pension, Retirement Gratuity, Commuted Value of Pension, Death Relief which having become admissible to me on re
remain unpaid of my death.
1.
SMT. R. LINGAVATHY
2.
WIFE
3.
Age
55 Years
4.
Full Amount
5.
Contigencies on the happening of which the nomination shall become invalid (Death
need not be mentioned)
6.
Name and address, relationship and age of alternative nominee(s) to whom the right
conferred on the nominee(s) in Column-I shall pass in the event of the nomination to
him/ her/ them becoming ineffective
----
NOT APPLICABLE
7.
The Government Servant shall draw lines across the blank space below the last entry to prevent the insertions of any
has signed.
Note:
Signature,
Address:
Name
and
2.
Signature,
Address:
Name
and
Designation:
Superintendent
O/o the District Ednl Officer
Nampally Mandal, Hyderabad District
COUNTER SIGNED
The Government Servant who has a family may nominate one member or more than one member or the family as defined in Rule 46(5) o
Rules, 1980
Note 2:
The Government Servant who has no family may nominate a person or persons, or a body of individuals, whether incorporated or not.
Note 3:
The Government Servant may note that the nomination with signature of two witness shall only have the legal validity of WILL.
Note 4:
This nomination form is to be submitted by the employees in triplicate, one for use of the Pension Sanctioning Authority and two copies t
Accountant General/ Local Audit Officers.
Note 5:
For the purpose of Rules 46, 47 and 49 of A.P. Revised Pension Rules, 1980, Family in relation to a Government Servant means:
i)
ii)
iii)
iv)
Unmarried daughters including step daughters posthumous daughters and adopted daughters (whose personal law permits such adoption.
v)
vi)
vii)
viii)
ix)
x)
xi)
ANNEXURE - II
NOMINATION
he wishes to make different nominations for each type of payment, mentioned below)
d below and confer on him /her /them the right to receive Life Time Arrears of Pension,
t, in the event of my death while in service and right to recieve on my death, Life Time
f Pension, Death Relief which having become admissible to me on retirement which may
SMT. R. LINGAVATHY
WIFE
55 Years
Full Amount
---NOT APPLICABLE
er on _________________ .
s the blank space below the last entry to prevent the insertions of any name after he/she
Hyderabad
one member or more than one member or the family as defined in Rule 46(5) of A.P. Revised Pension
h signature of two witness shall only have the legal validity of WILL.
s in triplicate, one for use of the Pension Sanctioning Authority and two copies to be forwarded to the
hters.
s.
ANNEXURE - III
BY REGISTERED POST
From:
Gaz. Head Master Gr-II,
Govt. High School, Malakpet,
Saidabad Mandal,
Hyderabad District.
(Pension Sanctioning Authority)
To:
The Accountant General (A & E),
Andhra Pradesh, Hyderabad-500004.
(Disciplinary Authority/ Appointing Authority/ Head of the Department
Sub:
Pension - Sanction of Pension and other retiring benefits in respect of SRI. RANGA DEVAN
Superintendent working at O/o the District Ednl Officer, Nampally Mandal, Hyderabad Distri
-o0o-
I am to inform you that, the Pensioner / Family Pensioner application from SRI. RANGA D
on 25-11-2011 as Superintendent was forwarded to AGAP / LFA on _____________ as per the record
disciplinary / judicial proceedings are against the above retiring / retired Government Employee. I req
whether any such case is pending / contemplated against the above retiring / retired Government Em
you to verify whether any such case is pending against the above employee which entails withholdin
pension or part of pension permanently or for specified period as laid down under Rule 9 of Revise
1980. If so the AG (A & E) / Deputy Accountant General (Pension), O/o the Accountant General
Pradesh, Hyderabad / Local Fund Officer may be intimated accordingly by name either by registered
special messenger within one month from the date of issue of this letter for withholding pensio
contemplated in Govt. Memo. No. 33764-A/55/PSC/93, Finance & Planning (FW-PSC) Department, dt
reiterated in Govt. Memo No. 37254/361/A2/Pen-I/98, Finance & Planning (FW-Pen.I) Department
Copies of such orders shall also be sent to the concerned Treasury Officer / P.P.O. for withholdin
benefits. In this connection the instructions issued in Para 2, Part-II B of G.O. Ms. No. 263, Finance
PSC) Department, dt:23-11-1998 may be scrupulously followed.
Yours Sincerely,
Station:
Hyderabad
Date:
Pension Sanctioning Au
Gaz. Head Master Gr
Govt. High School, Mal
Saidabad Mandal,
NEXURE - III
GISTERED POST
Para 2, Part-II B of G.O. Ms. No. 263, Finance & Planning (FW-
followed.
Yours Sincerely,
1. Last Pay Certificate of SRI. RANGA DEVANDAM, Superintendent of the O/o the District Ednl Officer, Nam
Hyderabad District.
2. He/she has been paid up to 25-11-2011 at the following rate:
Scale of Pay:
Basic Pay
Deductions
10900 =00
125 =00
A.P.G.L.I.S.
G.I.S.
D.A. @ 24.824
2706 =00
Prof. Tax
H.R.A.
2180 =00
Other if any
C.C.A.
130 =00
S.C.A.
550 =00
Other if any
500 =00
TOTAL
17091 =00
TOTAL
3. He/she made over charge of Superintendent, O/o the District Ednl Officer in the after noon of 25-11-20
4. Recoveries are to be made from the pay of the Government Servant as detailed in the recoveries.
5. He/she has been paid leave salary as detailed above deductions has been made as:
PERIOD
RATE
AMOUNT
8. The details at the Income-Tax recovered from him/her upto the date from beginning to the current ye
the recovers.
Date:
Place:
Signature of the
Certifying Officer.
T PAY CERTIFICATE
llowing rate:
Deductions
450 =00
30 =00
150 =00
200 =00
830 =00
the District Ednl Officer in the after noon of 25-11-2011.
_____________ to
_____________ to
_____________ to
_____________ to
________________.
m/her upto the date from beginning to the current year are noted on
Signature of the
Certifying Officer.
APPENDIX
DETAILS OF RECOVERIES
Nature of Recoveries
Amount of Rupees
To be recovered in
Installments
DEDUCTION MADE FROM THE LEAVE SALARY
Name of the
Month
April
May
June
July
August
September
October
November
December
January
February
March
Pay
Amount of Income
Tax recovered
APPENDIX
TAILS OF RECOVERIES
Installments
MADE FROM THE LEAVE SALARY
of . Rs.
of . Rs.
of . Rs.
of . Rs.
Remarks
NO DUES CERTIFICATE
This is to certify that, there are no any kind of dues to be recovered from SRI. RANGA D
Superintendent, Nampally Mandal, Hyderabad District.
1. Sales Proceedings of A.P. Trading Corporation.
2. Nationalised Text Books and Note Books as they are not supplied / supplied to him.
This is to certify that there are no any kind of allegations or pending charges against S
DEVANDAM, Superintendent, O/o the District Ednl Officer, Nampally Mandal, Hyderabad District.
This is to certify that, there are no any kind of Audit Objections / Paras Pending against S
DEVANDAM, Superintendent, O/o the District Ednl Officer, Nampally Mandal, Hyderabad District.
NON-SUSPENSION CERTIFICATE
This is to certify that SRI. RANGA DEVANDAM, Superintendent, O/o the District Ednl Office
Mandal, Hyderabad District.
RESPONSIBILITY CERTIFICATE
I, SRI. RANGA DEVANDAM S/o / D/o / W/o Sri. Ranga Sadanandam to be retired as Superinte
the school/office of O/o the District Ednl Officer, Nampally Mandal, Hyderabad District do hereby dec
any amount found to be excess paid due to erroneous caleculation noticed at a later date, I shall b
refund the same without any objection in the matter.
Station:
Date:
Pensioner
Drawing Officer
NO DUES CERTIFICATE
on.
IT OBJECTIONS CERTIFICATE
SUSPENSION CERTIFICATE
ONSIBILITY CERTIFICATE
Pensioner
(SRI. RANGA DEVANDAM)
Superintendent, O/o the District Ednl
Officer, Nampally Mandal.
From
To
Sir/Madam,
I am here with forwarding the advance Pension Papers in quadruplicate of SRI. RANGA D
Superintendent, O/o the District Ednl Officer, Nampally Mandal, Hyderabad District who is to retire on 25-11
The following documents are sent herewith for authorising pensionery benefits of the pensioner.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
The receipt of the advance pension papers along with Service Register may please be acknowl
necessary arrangements may please be made for issue of Pension Payment Order, Gratuity Payment
Commutation Authorization.
Yours faithfully,
To
Sri. Ranga Devandam, Superintendent, O/o
the District Ednl Officer.
004.
of the pensioner.
PROCEEDINGS OF THE GAZ. HEAD MASTER GR-II :: GOVT. HIGH SCHOOL, MALAKPET :: SAIDABA
HYDERABAD DISTRICT
Present : Sri. B. Venkateswarlu, B.Sc., B.Ed.
Rc.No. ___________________
Date: ____
Sub: Pension - Santion of Pensionery Benefits to Sri. Ranga Devandam, Superintendent, O/o t
Officer, Nampally Mandal, Hyderabad District who will retire from his/her service in the A.N.
- Orders Issued.
Ref:
1)
2)
3)
4)
5)
6)
In terms of the G.O's cited Pensionary Benefits are here by sanctioned to SRI. RANGA DEVANDAM,
O/o the District Ednl Officer, Nampally Mandal, Hyderabad District who will retire from his service on Super
A.N. of 25-11-2011. The Pensionary Benefits are payable at S.B.I., Malakpet Branch with A/c No. 10235678
Qualifying Service
Superannuation Pension
#VALUE!
Retirement Gratuity
Rs. 180280 /-
Commutation
#VALUE!
In case of Death of the Pensioner, the Family Pension Payable to Smt. R. Lingavathy Wife of Sri. Ra
Superintendent who is going to retire from O/o the District Ednl Officer Rs. 4377 /- period of upto 7 Year
Rs. 5243 /- till his/her remarriage of Wife or death which ever is earlier.
The Pensioner is informed that, if the amount now sanctioned is later found to be excess of what he/s
will be held responsible and called upon to refund such excess amount.
To
The individual concerned.
Copy forwarded to the A.G.A.P., Hyderabad along with the following documents on behalf
of Sri. Ranga Devandam and to release Pensionary Benefits at an early date.
1. Service Register.
2. Pension Proposals (3) sets.
: 23-11-1998.
dt: 07-05-2002.
25-05-1998.
04-10-2005.
16-09-1999.
y the incumbent.
-o0o-
DDO
Certified that, the following are the identification marks of Sri. Ranga Devandam who is retired
Superintendent from the office of the O/o the District Ednl Officer, Nampally Mandal, Hyderabad Distric
1. A mole on the left side of the stomache.
2. A mole on the right hand.
(Certifying Author
PHOTOS as per Govt. Finance (PS) Dept., Circular Memo No. 13910/90/A1/PSC/04, dt: 21
issued with reference to A.G's
Lr.No. PM/1/7-7/2004/05/U.IV/10, dt: 04-06-2004
1. Photos of Pensioner
2. Designation
: Superintendent
3. Office
4. Retires on
: 25-11-2011
(Certifying Authority)