February, 2014

New Delhi, the 20th February, 2014 [TO BEPUBLISHED IN THE GAZETTE OFINDlA EXTRAORDINARY, PART II, SECTION 3,SUB -SECTION (i)] Government ofIndia Minis...

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[TO BE PUBLISHED IN THE GAZETTE OF INDlA EXTRAORDINARY, PART II, SECTION 3, SUB - SECTION (i)]

Government Ministry of Personnel,PubJic Department

of India Grievances

and Pensions

of Pension and Pensioners'

Welfare

NOTIFICATION

New Delhi, the 20th February,

G.S.R

2014

- In exercise of the powers conferred by the proviso to article

309 and clause (5) of article 148 of the Constitution and after consultation

with the

Comptroller and Auditor General of India in relation to persons serving in the Indian Audit and Accounts Department, the President hereby makes the following rules further to amend the Central Civil Services (Pension) Rules, 1972, namely>

1.

(1) These rules may be called the Central

Civil Services

(Pension)

Amendment Rules, 2014.

(2)

They shall come into force on the date of their publication

in the

Official Gazette.

2.

In the Central Civil Services (Pension) Rules, 1972, for FonTI 3, Form 5, Form

7, Form 8, Form 10, Form 11, Form 12, Form 13, Form 14, Form 18, Form 19, Form 20, Form 21, Form 22 and Form 24, the following Forms shall respectively be substituted, namely-

"FORM 3 [See rule 54 (12)J Details of Family 1. / 3. 4.

Name of the Government servant Designation Date of birth Details of the members of family as on-----------------------:

S. No

Names of the members of family

Date of birth

Relationship with the officer

Marital status

Remarks

0)

(2)

(3)

(4)

(5)

(6)

Dated signature of Head of Office . (7)

1. 2. j ". 4. 5. 6.

,

7. 8. 9. 10.

r

hereby undertake to keep the above particulars up-to-date by notifying to the Head of the Office any addition or alteration.

Signature of Government servant Place:

Date:

Note 1. - The original Form submitted by the Government. servant is to be retained. All additions/alterations are to be recorded in this Form under the signature of Head of Office in Col 7. No new Form will substitute the original Form. However, the retiring Government. servant should submit the details of family afresh along with Form 5. Note 2. - The details of spouse, all children and parents (whether eligible for family pension or not) and disabled siblings (brothers and sisters) may be given. Note 3. - The Head of Office shall indicate the date of receipt of communication regarding addition or alteration in the family in the 'Remarks' column. The fact regarding disability or change of marital status of a family member should also be indicated in the 'Remarks' column. Note 4. - Wife and husband shall include judicially separated wife and husband.

"i

[Also see rules 5 (2),12,13

FORM 5 [See rules 59 (I) (c) & 61(1)] (I) and 15 (3) of Central Civil Services Rules. 1981]

(3),14

Particulars to be obtained by the Head of Office before the date of his retirement

from the retiring

(Commutation

Government

of Pension)

servant

eight

months

I. Name 2. (3) Permanent Account Number (b) Aadhaar No., if available

for Income Tax (PAN)

3. Specify a few marks of identification, ( i) (i i)

not less than two, if possible

4. Height

5. Address after retirement/permanent

address for future correspondence:

6. Bank Account No. to which pension is to be credited: (Joint account, either or survivor, with the spouse) (In case the Head of Office is satisfied that it is not possible for the retiring Government open a joint account for reasons beyond his/her control, this requirement may be relaxed).

servant

to

7. Name of the Branch of Bank through which pension is to be drawn (a) (b)

BSR code of the branch IFSC code of the branch

8. Indicate whether family pension is also admissible from any other source - Military or State Government and/or a Public Sector Undertaking/Autonomous body/Local Fund under the Central or a State Government 9.

I desire to commute provisions of the Central

Civil

% (up to 40%) of my superannuation pension Services (Commutation of Pension) Rules,

I am aware condition Enclosures

Place: Date:

that future good conduct of the pensioner/family for every grant of pension/family pension and its continuance. as per check-list

are enclosed.

pensioner

in accordance

with the

1981. shall

be an implied

Signature: Designation: Ministry/Department/Office: Mobile No.: EmaiIlD:

Note I: Commutation of pension is optional. Item 9 may be stuck off if the retiring Government servant does not desire to commute a percentage of pension. Note 2: A separate application for commutation of superannuation pension in Form I-A of Central Civil Services (Commutation of Pension) Rules, 1981 is required to be submitted in case the retiring Government servant desires to apply for Commutation of Pension after submission of this form but three months before retirement. Note 3: It is in the interest of the Government servant to provide E-mail lD and Mobile number, which facilitates future correspondence.

Check List of Documents

S.No.

Description

I. (a)

Two specimen signatures (to be furnished

(b)

')

to be submitted along with Form 5

of documents to be enclosed

Whether enclosed in a separate sheet)

Additional information (Only in case of an illiterate or disabled Government servant.) :Two slips each bearing the left hand thumb and finger impressions duly attested may be furnished by a person who is not literate and cannot sign his name. If such a Government servant on account of physical disability is unable to give left hand thumb and finger impressions he may give thumb and finger impressions of the right hand. Where a Government servant has lost both the hands, he may give his toe impressions. Impressions should be duly attested by a Gazetted Government servant. Three copies of passport size joint photograph with wife or husband. Where it is not possible for a Government servant to submit a photograph with his wife or her husband, he or she may submit separate photographs. The photographs shall be attested by the Head of Office. Three copies of passport size photograph of disabled child/siblings/dependent parents, if applicable. (To be attested by the Head of Office)

3.

Details of the family in Form 3.

4.

Undertaking Intelligence 1972

5.

Written statement any

for counting

6.

Undertaking for disbursing Bank

refunding

7.

Nomination

8.

Nomination for arrears of pension and commuted value of pension (if applied for commutation of pension) in Common Nomination Form

III Fonn 26, for those who served III Security-related or Organisations referred to in rule 8 of the CCS (Pension) Rules,

of period of service under rule 59(1.).(a),

any

excess

payment

made

by the

for gratuity, CGEGIS and GPF in Common Nomination

if

--

- --------

--

-- ---

_.-

-

. f

pension

Form

I

I

I

I

--

FORM 7 [See rules 58, 60, 61 (1) & (3) and rule 65(I)J Form for assessing Pension/Family Pension and Gratuity [To be sent six months before the Date of Retirement to the PAO] PART - I I.

Name of the retiring Government

"")

Father's/Husband's

3.

PAN No.

employee

name

4.

Height & Marks of Identification

5.

Date of Birth

6.

Service to which he/she belongs (indicate name of organised service, if any, otherwise say, General Central Service)

7.

Particulars

of post held at the time of retirement

-

(a) Name of the Office (b) Post held (c) Scale of pay/Pay Band & Grade pay of the post . (d) Basic Pay / pay in the Pay Band & Grade pay (e) Whether the appointment mentioned above was under Government or outside the Government on foreign service terms (f) If on foreign service, scale of pay/ pay band, pay in the pay band & grade pay of the post in the parent department 8.

Whether declared substantive the Central Government

9.

Date of beginning

in any post under

of service

10.

Date of ending of service

I I.

Cause of ending of service (please tick one)(a) Superannuation (Rule 35) (b) Voluntary retirement on surplus (Rule 29-A)

being

declared

(c) Voluntary/premature retirement at the ... initiative of the Government servant [under Rules 48, 48-A and FR 56 (k) ] (d) Premature retirement at the initiative of the Government [ Rule 48 or FR 56 (j) ] (e) Permanent absorption in public sector undertaking/autonomous body (Rule 37 or 37-A/37-B) (f) Invalidment on medical ground (Rule 38) (g) Due to abolition . (h) Compulsory

of post (Rule 39)

retirement

(Rule 40)

12.

13.

14.

15.

(i) Removal/dismissal from service (Rules 24 and 41 ) (j) Death In the case of compulsory retirement, the orders of the competent authority whether pension may be allowed at full rates or at reduced rates and in case of reduced rates, the percentage at which it is to be allowed (Please see Rule 40) In case of removal/dismissal from service whether orders of competent authority have been obtained for grant of compassionate allowance and if so, at what rate (Please see Rule 41) Particulars relating to military service, if any (a) Period of military service (b) Terminal benefits drawn/being drawn for military service (c) Whether opted for counting of military service towards civi I pension (Rule 19) (d) If answer to (c) above is in the affirmative, whether the terminal benefits have been refunded Particulars relating to service in autonomous body/State Government, if any (a) Particulars of service:

(b) Whether the above service is to be counted for pension

in the Government (c) Whether the autonomous organisation has discharged its pensionary liability to the Central Government 16 Whether any departmental or judicial proceedings in terms of rule 9 of the CCS (Pension) Rules, 1972 are pending ., against the retiring employee. (If yes, in terms of Rule 69, provisional pension will be admissible and gratuity will be withheld till the conclusion of departmental or judicial proceedings and issue offinal orders.) 17. Qualifying service (a) Details of omission, imperfection or deficiencies in the Service Book which have been ignored [under Rule 59 (1) (b) (ii)] (b) Period not counting as qualifying service (i) Boy service (2nd proviso to Rule 13) (ii) Extraordinary leave not counting as qualifying service (Rule 21) (iii) Periods of suspension not treated as qualifying service (Rule 23) (iv) Interruptions in service [Rule 27 (1) (b) and Rule 28 (c)] (v) Periods of foreign service with United Nations bodies for which United Nations pension has been availed (Rule 31)

.

(vi) Any other period not treated as qualifying service (give details) (c) Additions to qualifying service(i) Civil service (RuleJ8) (ii) Military service (Rule 19) (i i i) Benefit of service in an autonomous body (d) Net qualifying service (e) Qual ifying service expressed in terms of completed six monthly periods (Period of three months &above is to be treated as completed six monthly period (Rule 49) I 8. El1lOluments (a) Emoluments in terms of Rule 33 (b) Emoluments drawn during ten months preceding reti rement-

From

.

Amount

Note: If the officer was on foreign service immediately preceding retirement, the notional emoluments which he would have drawn under Government but for being on foreign service may be mentioned in items (a) and (b) above (Note 7 below Rule 33)

19

20.

(c) Average emoluments (Rule 34) (d) Emoluments or average emoluments (whichever is higher) to be reckoned for pension (Rule 49) (e) Emoluments reckoned for retirement gratuity/death gratuity (Rule 50) (f) Pay reckoned for family pension (Rule 54) Amount of retirement gratuity/death gratuity (Rule 50) (Refer S. No.9 of Calculation Sheet)

Details of Government dues recoverable out of gratuity (a) Licence fee for Government accommodation [see sub-rules (2), (3) and (4) of Rule 72] .(b) Dues referred to in Rule 73 (c) Amount indicated by Directorate of Estates to be withheld under sub-rule (5) of Rule 72 21. (a) Proposed pension/service gratuity (Rule 49) (b) Proposed dearness relief on pension (as on the date of retirement) (c) Date from which pension is to commence (Rule 83)

')')

Rate of Family Pension (a) Enhanced rate [Rule 54(3)] (b) Period for which family pension will be payable at enhanced rate (c) Ordinary rate [Rule 54(2)] (d) Date from which ordinary rate offamily pension wi II be payable

23.

24

Commutation of pension (a) Whether simultaneously applied for commutation of pension with the pension application (applicable only in the case of those who retire on superannuation pension) (b) The percentage of pension commuted (c) Amount of monthly pension commuted (d) Commuted value of pension (e) Amount of residuary pension after deducting Commuted portion (f) Date from which reduced pension is payable (g) Date from which commuted pension is to be restored Post-retirement address of the retiree

25.

e-maillD,

26

Mobile number, if any

ifany

Signature of tile Head of Office

II

'i

FORM 7 CHECK LIST FOR HEAD OF OFFICE FOR TIMELY PROCESSING RETIREMENT DUES I. 2. ')

J.

4. 5. 6. 7. 8.

9. 10. II.

12.

13. 14. 15. 16.

17. 18.

.Whether retiring employee is an allottee of Government accommodation If retiring employee is not an allottee of Government accommodation, date on which ,'No demand certificate' issued by the office The date on which action initiated to obtain the 'No demand certificate' from the Directorate of Estates as provided in rule 57Date of receipt of 'No demand certificate' from Directorate of Estates Date on which intimation regarding any recovery/withholding of amount from gratuity received from Directorate of Estates Date on which action initiated to assess the service and emoluments qualifying for 2ension as]:>I"ovidedin rule 59 Date on which action initiated to assess the Government dues other than the dues relating to allotment of Government accommodation as provided in rule 73 (I) Date on which the retiring Government servant was furnished blank Form 5 along with a certificate regarding the length of qualifying service and the emoluments/ average emoluments proposed to be reckoned for retirement gratuity and pension. Whether any objection received from the employee on the above certificate Date on which the employee submitted his aQplication for pension in Form 5 Whether nominations made in Common Nomination Forms for death gratuity/retirement gratuity (i) (ii) payment under CGEGIS (iii) amount of GPF, if applicable (iv) arrears of pension (v) commuted value of pension (if applicable) (i)

Has the retiring Government servant worked in any of the organisations mentioned in sub-rule 3A of rule 8 of the CCS (Pension) Rules, 1972 (ii) If yes, whether an undertaking in Form 26 has been obtained along with Form 5 and placed on record Whether Details of family in Form 3 attached Whether Medical certificate of incapaci'!y (for inval id pension) attached. Whether Statement of the savings effected and the reasons why employment could not be found elsewhere attached (if claim is for compensation pension or gratuity). Whether the Orders of the competent authority regarding grant of pension in the cases of compulsory retirement/dismissal/removal against Item No. 12 or 13 placed on record. Whether a statement indicating the reasons for delay in case the pension papers are not forwarded before six months of the retirement of Government servant attached. Whether brief statement leading to reinstatement of the Government servant attached (In case the Government servant has been reinstated after having been suspended, compulsorily retired, removed or dismissed from service.)

OF

PART II I. Date of receipt of pension papers by the Accounts Officer from Head of Office 2. Entitlements admitted A. Length of qualifying service B. Pension (i) Class of pension (ii) Amount of monthly pension (iii) Date of commencement C. Commutation of Pension (i) Portion of pension commuted, if any (ii) Commuted value of portion of pension commuted, ifany (iii) Residuary pension after commutation (iv) Date from which reduced pension is payable (v) Date of restoration of commuted portion of pension subject to the pensioner continuing to live D. Retirement/Death Gratuity (i) Total amount of gratuity (ii) Amount to be adjusted towards arrears of licence fee for Government accommodation and licence fee for retention of Govt. accommodation beyond retirement (Rule 72( I) and 72(4) (iii) Amount intimated by Directorate of Estates for being withheld on account of unassessed licence fee (Rule 72(5» (iv) Amount to be adjusted towards Government dues other than those pertaining to Government accommodation (Rule 73) (v) Net amount to be released immediately E. Family Pension (i) At enhanced rate (ii) Period for which Family Pension at enhanced rate is payable

.

(iii) At normal rate 3. Head of Account to which the amount of pension, retirement/death gratuity and family pension are to be debited

Accounts Officer

FORM 8 [See rule 61 (1)] [Form of letter to the Accounts Officer forwarding the pension papers of a Government servant]

No

.

Government of India Ministry of Department/Office Dated the To The Pay and Accounts Officerl Accountant-General

Subject:- Pension papers of Shri/Srnt./Kumari pension.

for authorisation of

Sir, I am Kumari

directed to forward herewith the pension papers of Shri/Smtl , of this Ministryl Department/Office for further necessary action.

2. The details of Government dues which will remain outstanding on the date of retirement of the Govt. servant and which need to be recovered out of the amount of retirement gratuity are indicated below (a) Balance of the house-building or conveyance advance (b) Overpayment of pay and allowances including leave salary (c) Income Tax deductible at source under the Income Tax Act, 1961 (43 of1961) (d) Arrears of licence fee for occupation of Government accommodation (e) The amount of licence fee for the retention of Government accommodation for the permissible period beyond the date of retirement (f) amount to be withheld as per intimation of the Directorate of Estates under rule 72(5), if any (g) Any other assessed dues and the nature thereof

Rs. Rs. Rs. Rs.

Rs. Rs. Rs.

i

)

I

!

f----

I I!

PENSION CALCULATJON SHEET I. Name

') 3 4. 5. 6. 7.

Designation Scale of pay/Pay Band & Grade pay Date of birth Date of entry in the Government service Date of retirement Length of qualifying service reckoned for pension/gratuity (as indicated in PPO) 8. Emoluments drawn during the last ten months 9. (I) Emoluments or A verage emoluments, whichever is more beneficial for pension (as indicated in PPO) (2) Pension admissible (if qualifying service is ten years or more) Calculations to be shown as follows :Emoluments or Average Emoluments/2 10. (1) Emoluments for gratuity (as indicated in PPO) (2) Retirement gratuity admissible Calculation to be shown as follows Emoluments/4 x Qualifying Service (In completed six monthly period, not exceeding 66.) II. (I) Pay for Family Pension (as indicated in PPO) (2) Family Pension admissible Calculations to be shown as follows :(a) Ordinary Family Pension: Pay X 30% subject to prescribed minimum and maximum (b) Enhanced Family Pension: Pay -i- 2 [Subject to prescribed per Rule 54].

minimum

and maximum

.

as

Head of Office

Countersigned

by PAO

Copy to:-ShrilSmt.lKumari retiring Govt. Servant

,

,

FORM 10 [See rule 77(2)] Form of letter to the nominee of a deceased Government servant where valid nomination for the grant of the death gratuity exists No

.

Government of India Ministry of. Department/Office

. . Dated the

.

To

Subject:-

Payment Kumari.

of

death

gratuity

in

respect

of

the

late

Shri/Smt.!

.

Sir/Madam, I am directed to state that in terms of the nomination made by the late Shri/Smt.. (Name & Designation) in the Office/Department/Ministry of. a death gratuity is payable to his/her nominee(s). A copy of the said nomination is enclosed herewith. 2. I am to request that a claim for the grant of the gratuity may be submitted by you in the enclosed Form 12. 3. Should any contingency have happened since the date of making the nomination, so as to render the nomination invalid, in whole or in part, precise details of the contingency may kindly be stated.

Yours faithfully,

Head of Office

3.

Your attention is invited to the enclosures forwarded herewith.

4. The receipt of this letter may be acknowledged and this Ministry/Department/Office informed that necessary instructions for the disbursement of pension have been issued to disbursing authority concerned, under intimation to the retiring Government servant/pensioner. 5. The retirement gratuity will be drawn and disbursed by this Ministry/Department/Office on receipt of authority from you. The outstanding Government dues as mentioned in paragraph 2 will also be recovered out of the retirement gratuity before making payment. Your faithfully,

Head of Office. List of enclosures 1) Form 5 and Form 7 duly completed, along with enclosures and checklists. 2) Service Book (date of retirement to be indicated in the service book). NOTES 1. When initials or name of the Government servant are or is incorrectly given in the various records consulted, this fact should be mentioned in the letter. 2. If a Government servant is compulsorily retired from service and delay is anticipated in obtaining Form 5 from the Government servant, the Head of Office may forward the pension papers to the Accounts Officer without Form 5. The Form 5 may be sent as soon as it is obtained from the Government servant.

FORM 11 [See ruJe 77(2)1 Form of Jetter to the member or members of the family of a deceased Government servant where vaJid nomination for the grant of the death gratuity does not exist No

. Government of India Ministry of . Department/Office . Dated the

.

To

Subject:-

Payment

Shri/Smt

of

death

gratuity

in

respect

of

the

late

.

Sir/Madam, I am directed to say that in terms of rules 50 and 51 of the Central Civil Services (Pension) Rules, 1972, a death gratuity is payable to the following members of the family of late Shri/Smt.. (Name and Designation), in the Office!Department! Ministry of in equal shares :(i)

Oi) (i) (ii)

Wife/husband including judicially separated wife/husband. Sons } Unmarried daughters } including step children and adopted children. widowed daughters }

2. In the event of there being no surviving member of the family as indicated above, the gratuity will be payable to the following members of the family in equal shares :(i) (ii) (iii) (iv) (v)

Father} Mother} including adoptive parents in case of individuals whose personal law permits adoption; Brothers below the age of eighteen years and unmarried and widowed sisters including step brothers and step sisters; Married daughters; and Children of a pre-deceased son.

3. It is requested that a claim for the payment of gratuity may be submitted in the enclosed Form 12 as soon as possible. Yours faithfully,

Head of Office

FORM 12 [See rule 77(2)] Form of application for the grant of death gratuity on the death of a Government servant (To be filled in separately by each claimant and in case the claimant is minor, the Form

should be filled in by the guardian on his/her behalf. Where there are more than one minor and one guardian for all of them, the guardian should claim gratuity in one Form on their behalf) (i)

(ii) (iii)

2

Name of the deceased Government servant in respect of whom gratuity is being claimed Date of death of Government servant Office/Department/Ministry in which the deceased served last Name and other details of claimant(s)Name

3.

4.

Date of birth

with

Relationship the deceased

Postal Address

_-_

In case the claimant(s) is/are minor, details of guardian•..... .._--_._ .., ..-----_ .._._-_._ .....•.... _--_._-_. ,---_ _-_ ..•_ _ Name Date Relationship' Relationship with . Postal Address of with the deceased the minor

..-.- ..-.-~.- --.,- - ...• ".----~

Details of Bank with Account No., IPSC Code for e-PaymentiECS

Signature/Thumbimpression of the claimant/ guardian Enclosures: (i) Death Certificate, (ii) Date of Birth Certificate, (in case of minors) (iii) Specimen signature/left hand thumb and claimant/ guardian.

finger

impressions

of

the

FORlv: ~3

!,c"e( rule

(F om) of tetter

Hi

f run: member

-7:3); of a deceased Govc:'nmen: F amil, Pensinn) }'-J (J

servant

for (Jnmt of

'"'

.

Government of India JvlinisTn of. .." Deparuneni/Office .... Daleo the

.

To

Subject.-

Payment

of Family

Pension

in respect

of the

tate

Shri/Smt.

Sir/Madam,

I am directed to state that in terms of rule 54 of the Central Civil Services (Pension) Rules, 1972, a family pension is payable to you in respect of the late Shri/Smt. Designation)

, in the Office/Department/

(Name Ministry

of

2. You are advised that a claim for the grant of Family Pension in the enclosed Form 14.

and .

may be submitted

3. In the event of death or ineligibility after re-marriage of the widow/widower. the Family Pension shall be granted to the eligible child or children. dependent parents or disabled siblings, if any, as per the provisions of rule 54 of Central Civil Service (Pension) Rules. 1972. In the case of a childless widow, the family pension shall be payable even after re-marriage subject to the condition that her earning is less than or equal to the sum of minimum family pension under the Central Civil Service (Pension) Rules, 1972 and Dearness Relief on it. 4.

Yours faithfully.

Head of Office

FORM

1..;

f See rule, -- (3) anc I~l \,2)·

Farm 0] appi ica:

(i

I

]\J

i011

ram i1.1pension

10:'

all death of 3 Governruen:

arne of the Government

whom

rarnilv pension

servant

is being

in respect

of

Office/Department/Ministry

(iii)

Date

(iv)

Date of death of Government family pensioner

servant/pensioner

servant/pensioner/

(V)

served

of Governmenr

PPO

No.

family

pensioner

Government

Name

and other details

of

Name

last servant

of claimantof

Dale

Relationship

birth

In

3.

case

the claimant details

Name

is minor

witl,

Postal

Address

the deceased Government

mental retardation,

II pensioner

ionerfanu

claimed

(ii )

of retirement

se.vanr.pens

or suffering

of guardian/nominee, Date of

Relationship

birth

the

servant

from disorder

applicable-

with

Relationship

minor!

mentally

disabled

claimant

or disability

wherever

of mind,

including

Postal

with

Address

the deceased Government servant

4. Details of surviving widow/widower, children, dependent deceased Government servant / pensioner are enclosed in Form .3. 5. Account

No., name and

parents

and disabled

BSR code of Branch of Bank to which family pension

Encl:

pensioner

of the

is to be credited:

6. Other source of family pension - Military or State Government and/or a Public Sector Autonomous body/Local Fund under the Central or a State Government if any ! am aware that future good conduct of the claimant/family cond ition for every grant of farn ily pension and its continuance.

siblings

shall

Undertaking/

be an imp! ied

As per the check-list. Signature

Signatures (i)

of two Witnesses

or left hand thum b impression of the claimant/guardian Mobile/Telephone No . Permanent Account Number for Income Tax (PAN) . Aadhar No., if available . with names and full addresses:

(i i) Note:

Form J 4 is not to be filled if the spouse had a joint account with the deceased pensioner. In such cases, family pension shall be allowed by the Pension Disbursing Authority on the basis of an application on plain paper. The permanently disabled children/siblings and dependent parents to whom family pension has been authorised in the PPO of the pensioner will submit this Form to the Pension Disbursing Authority.

FORM 18 [See rules 78(1), 80(1),80(3),80 (5), 80-B (1) and 80-B (5)] Form for assessing and authorising the payment of family pension and death gratuity when a Government servant dies while in service

PART I Section I I. Name of the deceased Government servant ...

2. 3. 4. 5. 6. 7.

Father's name ... Husband's name in the case of female Government servant. .. Date of birth (by Christian era) . Date of death (by Christian era) . Religion ... Particulars of post held at the time of death (a) Name of the Office (b) Post held substantively: (c) Officiating post: (d) Scale of pay/Pay Band & Grade Pay (e) Basic Pay/Pay in Pay Band & Grade Pay (f) Whether the last post held was under the Government or outside the Government on foreign service terms (g) If on foreign service, scale of pay/pay band, pay in the pay band and grade pay of the post in the parent department

8. Date of beginning of service ... 9. (i) Total period of military service, if any, for which pension and/or gratuity was sanctioned: (ii) Amount and nature of any pension/gratuity received for the military service ] O. Particulars relating to service in autonomous body/State Government, if any (a) Particulars of service: Organization

(b) (c)

Post held

Whether the above service is to be counted for gratuity in the Government Whether the autonomous organization has discharged its pensionary liability to the Central Government

11. Amount and nature of any pension/gratuity received for previous civil service, if any 12. Service qualifying for death gratuity(a) Details of omission, imperfection or deficiencies in the Service Book which have been ignored [under rule 59 (1) (b) (ii)]-

Check List of Documents to be submitted with Form 14 I.

Two specimen signatures of claimant (to be furnished in a separate sheet) duly attested by a Gazetted Government servant. (Two slips each bearing the left hand thumb and finger impressions duly attested may be furnished by a person who is not literate to sign his name. If such an on account of physical disability is unable to give left hand . . to' thumb and finger rmpressions he/she may gIve thumb and finzer impressions of the right hand. Where a Government servant has lost both the hands, he/she may give toe impressions. Impressions should be duly attested by a Gazetted Government servant.)

2.

Two copies of passport size photographs of the claimant, du ly attested

3.

Two slips showing the particulars of height and personal identification marks duly attested by a Gazetted Govt.

4.

Details of the family in Form 3. ..

S.

Certificate(s) of age showing the dates of birth of the children. The certificates should be from the Municipal authorities or fr0111the local panchayat or from the head of a recognized school or Central/State Board of Education.

6.

Undertaking for refunding disbursing Bank

7.

Specimen signature or left hand thumb and finger impressions of guardian duly attested, in the case of the guardian who is not literate enough to sign his or her name

8.

Two attested guardian/nominee

9.

Descriptive roll of the guardian/nominee, Showing the particulars height and identification marks, duly attested.

10.

Copy of PPO of previous pensioner/family

II.

Proof of permanent

address of the guardian.

12.

Copy of death pensioner/previous

certificate of family pensioner,

13.

Copy of document regarding pensioner, if applicable.

copres

any excess payment

of

passport

SIze

made by the pension

photograph

of

the

of

pensioner

the deceased if applicable.

ineligibility

of

employee

previous

or

family

Periods of non-qualifying service (i) interruption in service condoned under rules 27 & 28 (ii) Extraordinary leave not qualifying for gratuity (iii) Period of suspension treated as non-qualifying (iv) Boy service (2nd proviso to rule 13) (v) Periods of foreign service with United Nations bodies for which United Nations pension has been availed (Rule 31) (vi) Any other service not treated as qualifying service

(b)

From

To

Total period of non-qualifying service (c) Additions to qualifying service (i) Civil service (RuleI8) (ii) Military service (Rule 19) (iii) Benefit of service in an autonomous body Total period of qualifying service (d) Net qualifying service .(e) Qualifying service expressed in terms of completed six monthly periods (Period of three months &above is to be treated as completed six monthly period (Rule 49) 13.

(a) Emoluments reckoning for death gratuity ... (b) Amount of death gratuity ...

14. Details of Government dues recoverable out of death gratuity 0) Licence fee for occupation of Government accommodation [See rule 80-C] .... (ii) Amountto be withheld as indicated by the Directorate of Estates [See rule 80-C (i) (v)] . (iii) Dues referred to in rule 80-C (2) . 15. Net amount payable as death gratuity 16. Details of the nominee(s) to whom death gratuity is payable S. No.

Name

Share 1\1 death gratuity

17. Details of guardian/nominee minor/mentally disabled children S. No.

Name mentally child

of

minor/ disabled

Date ofBirth

Address

Relationship deceased servant

with Govt.

who will receive payment of death gratuity in the case of

Name of guardian

Address

of guardian

Relationship guardian deceased servant

of with Govt.

18. The date on which intimation regarding the death of Government servant was received by the Head of Office 19. The date on which action initiated to (i) obtain claim or claims from the claimants in the appropriate form for death gratuity and family pension as provided in rule 77: (ii) obtain the 'No demand certificate' from the Directorate of Estates as provided in rule 80-C (1): (iii) assess the Government dues other than the dues pertaining to occupation of Government accommodation as provided in rule 80-C (2): (iv) assess the service and emoluments qualifying for death gratuity and family pension as provided in rules 78 and 79. 20. Details of payment of Family PensionRate of fami ly pension

Amount pension

Enhanced rate [if service rendered time of death is more than seven years as in rule 54 (3)]

of family

Period for which it is payable From

To

at the

Ordinary rate Additional family pension, as on date, to old family pensioner, if any, under rule 54(2A)

21. Persons to whom family pension is payable (i) Name ... (ii) Relationship with the deceased Government servant ... (iii) Full postal address ... 22. Details of guardian who will receive payment of family pension in the case of minor/ mentally disabled children S. No.

Name mentally child

of

rn inorl disabled

Name of guardian

Address of guardian

Relationship of with guardian deceased Govt. servant

23. Head of Account to which death gratuity and family pension are debitable

Place Dated the

. Signature of Head of Office

PART II Account Enfacement Section I 1. (i) (ii)

Total period of qualifying service accepted for Death gratuity ... Total period of continuous service accepted for Family Pension

2. Net amount of death gratuity after adjusting Government dues 3. Amount and the period oftenability of Family.Pension Rate offamily pension

of Amount family pension

Period for which it is payable From To

Enhanced rate [if service rendered at 'the time of death is more than seven years as in rule 54 (3)] Ord inary rate Additionalfamily pension, .as on date, to Old family pensioner, if. any, under nile 54(2A)

4.

Date from which familypensionis.adniissible:

5.

Head of Accountto which death gratuity and family pension are debitable: Section

U

1. Name of thedeceased-Governmentservant ... 2. Date of death of the Government servant ... 3. Date on which pension papers received by the Accounts Officer ... 4. Amount offamily pension authorised ... 5. Amount of gratuity authorised '" . 6. Date of commencement of family pension ... 7. Date on which payment of family pension and gratuity authorised ... 8. Amount recoverable from gratuity '" '" ... 9. Amount of gratuity held over pending receipt of'N a demand certificate' ...

Place Dated, the

Accounts Officer

Section II Details of provisional family pension and gratuity to be drawn and disbursed by the Head of Office in accordance with rule 80A. Rs

p.rn.

Death Gratuity [amount mentioned in item 13(b) of Section I]

Rs

.

Less (3) Licence fee recoverable from gratuity for occupation of Government accommodation [as in item 14(i) of Section I]

Rs

Provisional family pension

.

.

(b) Amount of gratuity to be held over pending receipt of information from the Directorate of Estates [as the item 14(ii) of Section I] (c) Other Government dues as mentioned in item 14 (iii) of Section I

Rs

.

Rs

.

(d) Total of (a), (b) and (c)

Rs

.

Place Dated, the

Signature of Head of Office

FORM 19 (See rule 81) Form of letter to the Accounts Officer forwarding papers for the grant of family pension and death gratuity to the family of a Government servant who dies while in service No . Government of India Ministry of. . Department/Office . Dated the

.

To The Pay and Accounts Officer

Subject:- Grant of family pension and death gratuity. am

directed

to

say

that Shri/Smt.lKumari (Name and designation) died on His family has become eligible for the grant of family pension and death gratuity. Form 18 duly completed is forwarded herewith for further necessary action. 2. Government dues in respect of the deceased Government servant will be recovered out of the death gratuity as indicated in Section II of Part I of Form 18. 3. Your attention is invited to the enclosures forwarded herewith. 4. The receipt of this letter may be acknowledged and this Ministry/Department/Office informed that necessary instructions for the disbursement of family pension and death gratuity have been issued to the disbursing authority concerned, under intimation to family pensioner.

Yours faithfully,

Head of Office

List of enclosures 1. Forms 14 (along with check-list) and Form 18 duly completed. 2. Service book (date of death to be indicated in the service book).

, .

FORM 20 [See rule 81(2)] Form of letter sanctioning Family Pension to a member (other than spouse) on death of a retired Government servant No . Government of India Ministry of. . Department/Office . Dated the

.

To The Pay and Accounts Officer

Subject:- Grant of Family Pension to the child/children/dependent

parents/disabled siblings.

Sir/Madam, I am formerly pension of Rs from service.

directed

to

say that Shri/Smt. . (Designation) in this Ministry/Department was authorized with effect from on his/her retirement

2. Intimation has been received in this Ministry/Department/Office that Shri/Smt. . .............. .., died on and that at the time of death left no widow/widower but was survived by the following members of family:-

SI. No.

Name

Date of Birth

Address

Relationship with deceased pensioner

Whether s ufferi n g from any disability

Marital status

3. In terms of rule 54 of the Central Civil Services (Pension) Rules, 1972, the amount of Family Pension has become payable to Shri/Kumari/Smt..................................... The Family Pension will be payable, on behalf of the minor/mentally disabled child, to Shri/Smt. .................................................... who is the nominee/guardian. 4. Sanction for the grant of Family Pension of Rs per month to Shri/Kumari/Smt. . . .. . .. . .. ... . .. . ... ... .. . . .. . . .. . .. is hereby accorded. The Family Pension will take effect from and will be tenable as per the provisions of sub-rule (6) of rule 54 of the Central Civil Services (Pension) Rules, 1972. 5.

The Family Pension is debitable to the Head

.

6.

Your attention is invited to the enclosures forwarded herewith.

7. The receipt of this letter may be acknowledged and this Ministry/Department/Office informed that necessary instructions for the disbursement of family pension have been issued to the disbursing authority concerned, under intimation to family pensioner.

Yours faithfully,

Head of Office List of enclosures1. Forms 14 (along with check-list)

FORM 21 [See rule 81(2)J Form of letter sanctioning Family Pension to another member of family on death or Ineligibility of a recipient of Family Pension

No

.

Government of India Ministry of. Department/Office

. . Dated the

.

To The Pay and Accounts Officer

Subject:- Grant of Family Pension on death or ineligibility of a recipient of Family Pension. Sir. I am directed to say that Shri/Smt. . (relationship) of late Shri/Smt. formerly .................................... (designation) in this Ministry/Department/Offi ce was authorised the payment of Family Pension of Rs with effect from . vide PPO No . 2. Intimation has been .. . .. .......................... on

received

in this Ministry/Department/Office that Shri/Smt.lKm . died/ceased to be eligible for family pension on account of (date).

There are the following survrving servant/pensioner: 3.

S. No.

Name

Date of Birth

members of family of the deceased Government

Address

Relationship with deceased pensioner

Whether suffering from any disability

Marital status

4. In terms of rule 54 of the Central Civil Services (Pension) Rules, 1972, the amount of Family Pension has become payable to Shri/Kumari/Smt..................................... The Family Pension will be payable on behalf of the minor/mentally disabled child to Shri/Smt. ..................................................... who is the nominee/guardian. 5. Sanction for the grant of Family Pension of Rs per month to Shri/Kumari/Smt. is hereby accorded. The Family Pension will take effect from and will be tenable as per the provisions of sub-rule (6) of rule 54 of the Central Civil Services (Pension) Rules, 1972.

6.

The Family Pension is debitable to the Head

7.

Your attention is invited to the enclosures forwarded herewith.

.

8. The receipt of this letter may be acknowledged and this Ministry/Department/Office informed that necessary instructions for the disbursement of family pension have been issued to the disbursing authority concerned, under intimation to family pensioner.

Yours faithfully,

Head of Office List of enclosures1. FonTI 14 (along with check-list)

FORM 22 [See rule 81(4)] Form of application for the grant of Residuary Gratuity on the death of a pensioner (To be tilled in separately by each claimant) 1.

(i) Name of the pensioner in respect residuary gratuity is being claimed (ii) Office/Department/Ministry served last

of

whom

(iii) Date of retirement

of pensioner (i v) Date of death of pensioner (v) PPO No. of pensioner,

2.

if applicable

Name and other details of claimant(s)-

S. No.

Name

Date of birth

Relationship with the deceased pensioner

Postal Address

3. In case the claimant(s) is/are minor or suffering from disorder or disability of mind, including mental retardation, details of guardian...........................................................................

Name

Relationship with the minor

the deceased

pensioner

4. Account No., name and BSR code of the Branch of Bank to which amount is to be credited: 5. Amount of monthly pension (including ad hoc increase, if any)/service gratuity sanctioned to deceased pensioner: 6. Amount of retirement gratuity received by the deceased pensioner: 7. The amount of pension (including ad hoc increase, if any)/service gratuity drawn by the deceased till the date of death: 8. If the deceased had commuted a portion of pension before his death, the commuted value of the pension: 9. Total of items 6,7 and 8: 10. Amount of death gratuity equal to 12 times of the emoluments: 11. The amount of residuary gratuity claimed, i.e., the difference between the amount shown against items 10 and 9: Enel: Specimen signatures/thumb impression duly attested by a Gazetted Government servant Signature or left hand thumb impression of the claimant/guardian Mobile/Telephone No . Permanent Account Number for Income Tax (PAN) . Aadhar No., if available . Signatures oftwo Witnesses with names and full addresses: (i) (i i)

Note 1.- If a retired Government servant in receipt of service gratuity or pension dies within five years from the date of his retirement from service including compulsory retirement as a penalty and the sums actually received by him at the time of his death on account of such gratuity or pension including ad-hoc increase, if any, together with the death-cum-retirement gratuity and the commuted value of any portion of pension commuted by him are less than the amount equal to 12 times of his emoluments, a residuary gratuity equal to the deficiency becomes payable to the family. When a Government servant has retired before earning a pension, the amount of service gratuity should be indicated. Note 2.- Two specimen signatures duly attested by a Gazetted Government servant (to be furnished in a separate sheet). Two slips each bearing the left hand thumb and finger impressions duly attested may be furnished by a person who is not literate to sign his name. Ifsuch a person on account of physical disability is unable to give left hand thumb and finger impressions, he/she may give thumb and finger impressions of the right hand. Where a Government servant has lost both the hands, he/she may give toe impressions. Impressions should be duly attested by a Gazetted Government servant.

FORM 23 ISee rule 38(3)J Form of Medical Certificate Certified that I1CWe) have carefully examined AB son of CD, a ........... in the His age by his own statement is years, and by appearance about. years. I1CWe) consider AB to be completely and permanently incapacitated for further service of any kind in the Department to which he belongs in consequence of (here state disease or cause). (If the incapacity does not appear to be complete and permanent, the certificate should be modified accordingly and the following addition should be made.) "I am/We are of opinion that AB is fit for further service of a less laborious character than that which he had been doing/may, after resting for . months, be fit for further service of less laborious character than that which he had been doing. "

Place Dated the Medical Authority

FORM 24 [See rule 32] Form of certificate of verification of service for pension No Government of India Ministry of Department/Office Dated the Certificate is certified, in consultation with the Accounts Officer, that Shri/Smt..Km . .. . . , , .. , (Name and Designation) has completed a qualifying service of years months, days as on (date), as per details given below. The service has been verified on the basis of his service documents-and in accordance with the rules regarding qualifying service in force at present. The verification of service under sub-rules (1) and (2) of rule 32 of the Central Civil Services (Pension) Rules, 1972, shall be treated as final and shall not be re-opened except when necessitated by a subsequent change in the rules and orders governing the conditions under which the service qualifies for pension. It

DETAILS OF QUALIFYING SERVIC~ S. No.

Name of Ministry/Department/Office

From

To

Length of qualifying service

1. 2. '1

J.

Signature & Stamp of Head of Office To Shri (Name & Designation)"

.

fF.No.1I19/2013-P&PW

(E)]

~.

, (Sujasha ChOUd~ Deputy Secretary Note: The principal rules were published vide number S.O.934, dated the 1SI April, 1972. The Fourth Edition of the rules corrected up to July, 1988 was published in the year of 1988. The said rules were subsequently amended vide notifications given below:-

I. 2. ,.,

,).

4. 5. 6. 7. 8. 9.

10. 11. 12. 13. 14. IS. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27 28. 29. 30. 31. 32. ,.,,., . 34. 35. 36. 37. 38. 39. ,),)

S.0.254, dated the 4th February, 1989 S.0.970, dated the 6th May, 1989 S.0.2467, dated the 7'h October, 1989 S.0.899, dated the 14th April, 1990 S.0.1454, dated the 26th May, 1990 S.0.2329, dated the 8th September, 1990 S.0.3269, dated the 8th December, 1990 S.0.3270, dated the 8th December, 1990 S.0.3273, dated the 8th December, 1990 S.0.409, dated the 9th December, 1991 S.0.464, dated the 16th February, 1991 S.0.2287, dated the 7th September, 1991 S.0.2740, dated the 2nd November, 1991 GSR 677, dated the 7th December, 1991 GSR 399, dated the 1 st February, 1992 GSR 55, dated the 15th February, 1992 GSR 570, dated the 19th December, 1992 S.0.258, dated the 13th February, 1993 S.0.l673, dated the 7th August, 1993 GSR 449, dated the 11 th September, 1993 S.0.1984, dated the 25th September, 1993 GSR 389(E), dated the 18th April, 1994 S.0.1775, dated the 19th July, 1997 S.0.259, dated the 30th January, 1999 S.0.904(E), dated the 30th September, 2000 S.0.717(E), dated the 27th July, 2001 GSR 75(E), dated the 1st February, 2002 S.0.4000, dated the 28th December, 2002 S.O. 860(E), dated the 28th July, 2003 S.O. 1483 (E), dated the 30th December, 2003 S.O. 1487 (E), dated the 14th October, 2005 GSR 723(E), dated the 23rd November, 2006 S.O. 1821 (E), dated the 25th October, 2007 GSR 258 (E), dated the 31st March, 2008 S.O. 1028 (E), dated the 25th April, 2008 S.O. 829(E), dated the12th April, 2010 GSR 176, dated the 11th June, 2011 GSR 928 (E), dated the 26th December, 2012 GSR 938 (E), dated the 27th December, 2012