PENSION PAPERS OF

Mr. _______________ Designation__________

Postal Address:

House No.

INSTRUCTIONS
1. The Head of the Department or Office responsible for initiating the case should state filing in Section (2) (5) of Part-II of the working copy of the form one year before the expected date of retirement. 2. Six months before the date of retirement, the pensioner should be asked to fill in and sign Part-I in a fresh copy of the form and submit it alongwith the required enclosures mentioned in the last paragraph of the application for pension. 3. Part-I of the working copy will then be filled in by copying from Part-I of the signed copy received back from the applicant. Similarly, Section (3) to (5), Part-II of the signed copy will be filled in by copying from Part-III of the working copy. Section (I) of the Part-II of both the forms should then be filled in. 4. The signed copy should be forwarded to the sanctioning authority after filling in and signing Section (6), while the working copy will be retained in the initiating office as an office copy, if any extra enclosures such as list of family members, Death Certificate, invalid Certificate etc. are required by the special nature of a case, these should be attached with the form sent to the Audit Office. 5. The sanctioning authority should fill in Section (7) of the form and send it to the Audit Office alongwith forwarding letter. 6. The Audit Officer after scrutinizing parts-I and II and arriving at his own findings about the correct length of qualifying service and amounts of pension and Gratuity admissible, copy the gist of his findings from his working papers into Part-III. The form will then be filed as a record of the Audit Office. 7. Before filling in the form please read Chapter-V of the Punjab Civil Services Pension Rules.

PART-I
(To be filled in and signed by the applicant himself)

APPLICATION FOR PENSION AND / OR GRATUITY

To The _____________ _________________ _________________ _________________ Sir, I have the honour to say that I shall retire from Government Service with effect from ________________. I, therefore, requested that the pension admissible under the rules may kindly be sanctioned to me. 2. The Service in respect of which I am now applying for pension

commenced on __________________. I declare that I have neither applied for nor received and pension or gratuity for any part on of the service nor shall I submit any application hereafter without quoting a reference to this application and to the order which may be passed on it. 3. Should the amount of the pension and or gratuity granted to me be

afterwards found to be in excess of that to which I am entitled under the rules. I hereby undertake to refund any such excess. 4. I wish to draw my pension from the Government of the Punjab at

__________________ necessary entries to this office may therefore kindly be made in my pension papers. 5. i) ii) iii) The Following documents duly attested are enclosed: Three specimen signatures of mine. Three photographs of mine. Two sets of my thumb and finger impression on the prescribed form. Yours obedient servant Signature Name S/o ____________________ ____________________ ____________________

Post held on the date of retirement _____________________ Postal Address Dated __________ _____________________

PART-II
(To be completed by the Office / Department receiving the application for pension)

Section (I)
(To be completed after receiving the pension application) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Name of applicant Fathers name Nationality Postal address Post held on the date of retirement Date of birth of the applicant Height Marks of Identification Date of commencement of Service Date of retirement Date of application for pension Length of service including interruption, is _____ out of this, the length of non-qualifying service and interruption is _____ Out of commencement and ending of each spell of military service, if any: Y M D From to i.e. From to i.e Total: 12. Governments under which service has been rendered in chronological orders: Y M D Government of from to i.e. Government of from to i.e. Total: 13. 14. 15. 16. 17. 18. 19. Class of pension gratuity applied for (Average) emoluments Proposed ordinary pension Proposed special additional pension if any Proposed gratuity Place of payment (Government Treasury or S/Treasury) Date from which pension is to commence Signature of the Head of the Office / Department Head ________________________

Section (2) Calculation of Qualifying Service

Y Total length of service, including interruptions Non qualifying service From to Y i) ii) iii) iv) v) vi) vii) Service rendered below the age of 20 year Extraordinary leave Suspension not treated as duty or as leave Periods of breaks in service Service rendered before break, if break is not condoned. Service forfeited by resignation Unauthorized absence Total: Net qualifying service _______________ From Y i) ii) iii) Periods if any of Military Service of War Service allowed to count for pension Benefit of condonation of deficiency in service Any other additional to qualifying service Total: Total qualifying service ____________________ Signature of the Head of the Office / Department Head ________________________ M to D M D M D

Section (3) Calculation of Ordinary Pension

The date of retirement is _____________________. Hence, the proceeding 36-months extending from _______________ to ____________ have been taken into consideration in the calculation of average emoluments. Statement of emoluments during the last 12-months. Period From To Duration in months & days M D Monthly rate of emoluments Rs. Amount drawn Rs. Ps.

The total emoluments for

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Therefore, average emoluments work out to As the length of qualifying service year, the amount of gross ordinary pension will be Less 1/4th (if the applicant comes under the Pension-cum-Gratuity Scheme) Amount of net ordinary pension

Rs. _____ Rs. ___ Rs. ___ Rs. ___

Signature of the Head of the Office / Department Head ________________________

Section (4) Calculation of Special Additional pension

No. of completed year of effective service in *Grade-III No. of completed year of effective service in *Grade-II No. of completed year of effective service in *Grade-I Amount of special additional pension in Grade-III (Ax25 subject to the maximum of Rs. 125) Amount of special additional pension in Grade-II (Ax25 subject to the maximum of Rs. 205) Amount of special additional pension in Grade-I (Ax25 subject to the maximum of Rs. 350) Amount of special additional Pension admissible after applying the maximum prescribed in note below Less (if the applicant come under the pension-cumGratuity Scheme). Amount of net special additional pension ___________Year (A) ___________Year (B) ___________Year (C) Rs. ___________ P.M RS. ___________ P.M Rs. ___________ P.M Rs. ___________ P.M Rs. ___________ P.M Rs. ___________ P.M

* for officer drawing pay above Rs. 3,000 but not exceeding Rs. 3,250 per month of Rs. 25 per months for every completed year of effective service. * For officer drawing pay above Rs. 3,250 but not exceeding Rs. 3,500 per month at Rs. 45 per month for every completed year of effective service. * For officer drawing pay above Rs. 3,500 per month at Rs. 70 er month for every completed year of effective service. Note: The combined maximum of Special Additional Pension, Grade-II and Grade-III shall be Rs. 225 per month and the combined maximum of Special Additional Pensions of all the Grades shall be Rs. 350 permonth.

TOTAL NET PENSION

Amount of net Ordinary Pension Amount of net Special Additional Pension Amount of total net Pension Rs. ______ Rs. ______ Rs. ______

Signature of the Head of the Office / Department Head ________________________

Section (5) Calculation of Gratuity

Amount of ordinary pension surrendered [See Section (3)] Amount of special additional pension surrendered [see Section (4)] Total amount surrendered Length of qualifying service Rate of gratuity for every rupees surrendered Lump sum gratuity admissible Rs. ___ Rs. ___ Rs. ____ _____ years _____Rs. ____Rs.

Signature of the Head of the Office / Department Head ________________________

Section (6) Remarks by Head of office Department

(To be completed only after receiving the Pension Application)

1.

Character and past conduct of the applicant

2.

Remarks regarding and gratuity or Pension received by the applicant 9see Chapter IX of West Pakistan Civil Service Pension Rules)

3.

Specific remarks as to whether the service claimed is established and whether it should be admitted for pension or not 9see Rule 5.3 (2) West Pakistan Civil Service Rules)

4.

Remarks as to Special Additional Pension stating whether or not the service rendered in a qualifying post in Grade-III and / or II and / or I satisfies the standard of work and conduct required in the special conditions of the post of duty for the grant of full special additional pension.

5.

Any other remarks

Signature of the Head of the Office / Department Head ________________________

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Section (7) Orders of the Sanctioning Authority

1. The undersigned is satisfied that the service of Mr. ____________ has been wholly satisfactory. The grant of full pension and / or gratuity which the Audit Officer may fine to be admissible under the rules is hereby sanctioned. The undersigned is satisfied that the service of Mr. ________________ has not been wholly satisfactory and it has been decided that the full pension and / or gratuity found by the Audit Officer to be admissible under the rules should be reduced by the specific amount or percentages given below: Amount or percentage of reduction in pension Amount or percentage of reduction in gratuity __________ __________

Sanction is hereby accorded to the grant of pension and / or gratuity as so reduced. 2. The following periods of service of the officer has been approved for the grant of special additional pension under the rule.

GRADE-III
Period of Service Postal / posts held _____________________ _____________________

GRADE-II
Period of Service Postal / posts held _____________________ _____________________

GRADE-I
Period of Service Postal / posts held 3. _____________________ _____________________

The payment of pension and / or gratuity may commence from _________ before issuing the pension payment order, the Audit Officer may kindly ascertain whether the Last Pay and No Demand Certificate have been received by him.

Signature of the Head of the Office / Department Head ________________________

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PART-III
(For use in the Account Generals / Comptrollers Office) i) ii) iii) iv) v) vi) The calculations contained in the preceding pages have been checked. Length of qualifying service accepted in Audit Reasons for differences, if any between this and the length of qualifying service worked out by the Department. Amount of Pension the Department Length of effective service in the: Grade-III _________________________________ years Grade-II _________________________________ years Grade-I _________________________________ years vii) viii) ix) x) xi) xii) Amount of special additional pension the Department. Amount of lump sum gratuity the Department. The Pension will commence from ___________________ Allocation of the pension and gratuity: Pension Government of Government of Government of Defence Estimates Total:Rs. Rs. Rs. Rs. Gratuity Rs. ___________ Reasons for discrepancy, in any between this amount and that calculated by Rs. ___________ Reasons for discrepancy, if any between this amount and that calculated by Rs. __________ Reasons for discrepancy, if any between this amount and that calculated by

xiii)

Anticipatory pension of Rs. _____________ Rupees ___________________) per month, granted with effect from ___________________________ vide PPO No. ___________________ dated ___________ to be adjusted in the final PPO.

xiv)

Amount of original pension commuted

Rs. ____________

Assistant Accountant-General Assistant Accounts Officer

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CERTIFICATE

1.

Checked with the LPC and No Demand Certificate / written consent vide Para 3 of Section (7), Part-II.

2.

PPO issued vide No. ___________________ dated ______________.

Assistant Accountant-General Assistant Accounts Officer