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SETTLEMENT FORMS FOR RETIRING RAILWAY EMPLOYEES
· 2018-11-12
Circularstaff-establishment
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| Date | 2018-11-12 |
|---|---|
| Type | VCRC archived Railway commercial circular / manual |
| Topic | staff-establishment |
| Archive source | vcrc.in |
Summary
Settlement Forms to be filled by the retiring Railway servant which ordinary Gratuity/Pension/Death-cum-Gratuity is claimed herein, nor shall | submit an application
Text of the circular
SNo.24 GOVERNMENT OF INDIA(BHARAT SARKAR) ०० MINISTRY OF RAILWAYS (RAIL MANTRALAYA) BE Pg (RAILWAY BOARD) v oa 2016/F(E)III/ (1)/8 New Delhi, dated: 7 ( .01.2019. Zonal Railways/Production Units. (As per mailing list) Sub: Settlement Forms to be filled by the retiring Railway servant. RRRKKEKK Attention of the Zonal Railway/Production units is invited to Board's letter of even number dated 12.11.2018 on the above subject vide which a set of settlement forms to be filled in by the retiring railway employees was circulated. The said set of settlement forms has been modified to include the option for Cashless Treatment Scheme in Emergency (CTSE) as well. 2. Accordingly, in partial Supersession of the letter dated 12.11.2018, a modified set of settlement forms is enclosed herewith for compliance and guidance. Other instructions contained in the letter dated 12.11.2018 will remain the same. 3. Please Acknowledge receipt. द hive Sadao धर fe riya Sudarsani) Director, Finance(Estt.) Railway Board. D.A.: As above. o\e मिलाकर" हि Application Form for payment of Pension & other Retirement Benefits to the Railway employees. (Note : Application Form to be filled up in all respect by the employee and submitted in triplicate ) furnish below my relevant particulars and request to arrange to pay me DCRG/Gratuity, SRPF, CGEGIS & Pension and may be permitted to commute eee percent) of my pension:- T. Full Name (in Block Letters) : 2. Father’s/Husband’s Name : 5. Designation 11. Mobile Number 13. Aadhaar No. 15. Religion...................+- 16. Present/Correspondence Address with PIN Code 17. Permanent Address with PIN Code 18. Details of Railway/ Directorate of Estate Quarter, if allotted 19. Date of Retirement 21. Class of Pension 22 Details of Public Sector Bank from where pension will be drawn : (a) Savings Bank Account No. (c) (e) 23. Medical facility being availed Branch District : Superannuation/Voluntary etc. (b) (d) (f) 24. at present (CGHS/RMA) 25. Details of Military / Other Service, if any (a) Total Period of Military Service (b) Amount of gratuity received for the Military Service (c) PPO No & Date of Issue (attach a self attested photocopy of the PPO) Date of Appointment RUID Number Pay Levelt PAN No. E-mail Id Mark of Identification no | ...... ........८८८पप deseea cae cuesaecaesasceessesaecasceeeeeueeseesneeens oh ...... .......८८. पद लि ...... cseeseeeceesescsescseseecsescseeees 20. Date of start of Pension City FSC : ,.................. ८ Medical Card(s) No. Note : Please attach : (i) a cancelled cheque, issued for Bank Account mentioned above at S.No.22, (ii) self attested photocopies of PAN, Aadhaar and Medical Cards Place : 5.5 Lack sseoneseimaei-nteinieneunamininrene Date: ............ Employee’s Signature Amnsune -1 DECLARATION FOR NON ACCEPTING COMMERCIAL EMPLOYMENT | note that | cannot accept any commercial employment before the expiry of one year from the date of retirement, or any employment under a government outside India at any time without prior sanction of the President of India. | cannot seek employment as contractor for or in connection with the execution of public works (Whether on the Railways, or under P.W.D. or Defence Forces) or employment of such contractors, within one year of my retirement, without the prior permission of the President of India. DECLARATION FOR NON RECEIPT OF PENSIONARY BENEFITS | hereby declare that | have neither applied for nor received any ordinary Gratuity/Pension/Death-cum- retirement Gratuity in respect of any portion of the service included in this application and in respect of which ordinary Gratuity/Pension/Death-cum-Gratuity is claimed herein, nor shall | submit an application hereafter without quoting a reference to this application and to the orders which may be passed thereon. | am in occupation of Railway / Directorate of Estates’ (DOE) HOUSE पि०.................................... on my retirement from Railway
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