FORM C

APPLICATION FOR GRANTS FROM THE WAPDA WELFARE

FUND
TO BE FILLED IN BY THE APPLICANT
1. Name of Wapda employee

________________________________

2. Date of death, invalidation or retirement in

case of deceased employee (Not applicable ________________________________
in case of serving employees).
3. (a) Detail of dependent family members,
Such as name, ages, whether married
Or unmarried, school or college where
being educated , relationship of each with ________________________________
the Wapda employee(Applicable in all cases).
(b) Detail of earning family members,
Not included in item (a) above and their
monthly income.
4. Detail of property left by Wapda
Employee for his dependents (applicable
In case of deceased employee only)
I)II)-

Moveable, Including each

Immovable

5. If the Wapda employee was insured, the

amount for insured (Only for deceased
employee).
6. Reason for the application with proof
7. In the case of application by a widow ,
a statement to the effect that she has not
married.

________________________________

________________________________
________________________________
________________________________

________________________________

________________________________
________________________________

I do hereby solemnly affirm and verify that the contents of above application are true to the best
of my knowledge and belief and that I have concealed nothing.
I know that in the event of making a willful misrepresentation of suppression of facts, I shall be
liable to criminal prosecution.

Signature and name of the employee

________________________________

Or
Signature of applicant alongwith name
And relationship with deceased employee

Address:

___________________________________

____________________________________________________________________

_________________________________________________________________________________

TO BE FILLED IN BY THE OFFICE IN WHICH THE WAPDA EMPLOYEE LAST

SERVED/ PRESENTABLY SERVING

G.P Fund A/C # _________________________

1. Date of entry into Wapda service

_________________________________

2. Date of birth as per service record.

_________________________________

3. Total length of service at the time of death,

invalidation or retirement and in the case of
serving employees total service till the date of ________________________________
filling application.
4. a)

b)

5. I)
II)

Post held at the time of retirement

of at the time death or invalidation
________________________________
before retirement.
Post held at present in case of serving ________________________________
employee.
Last pay drawn.

________________________________

Scale of pay.

________________________________

6. Amount and date from which pension/gratuity

/compensation has been granted by Wapda in ________________________________
the case of deceased / retired/invalided employee
7. Date from which contribution to the Wapda
Welfare Fund

________________________________

I certain and attest the details furnished above from the record in the office and .
I)-

Recommend

II)-

Do not recommend the case for reasons

8. The deceased was a Wapda employee at the ________________________________
time of death.
9. The deceased was a regular Wapda employee________________________________

Signature and name of Head of

Office/ Division with official seal.

CERTIFICATE

It is certified that Mr._________________________________________

S/o _________________________________________ Working as ______________________
Under__________________________________________________________ has applied for
marriage grant for 1st time not availed this facility in the past.

Countersignature

Signature of Applicant

CERTIFICATE

This is to certify that the name of official is Mr._____________________________________

S/o _________________________________________ For who, the marriage grant has been
applied.

Countersignature

CERTIFICATE

This is to certify that Mr.________________________________________________________

S/o _________________________________________member of Wapda Welfare Fund and the
deduction is remitted the managing committee welfare fund since his appointment in the
department.

Countersignature

CERTIFICATE

This is certified that Mr._______________________________________

S/o _________________________________________ working as ______________________
Is drawing basic pay of Rs:_____________ in BPS _____________.

Countersignature

AFFIDAVIT

I do hereby solemnly affirm that, I did not avail the facility of Marriage
Grant before this. In the event of making miss-representation of facts, I shall be liable to
original prosecution.

Signature & Designation

LIST OF FAMILY MEMBERS

Mr.___________________________________S/o_____________________________________
working as ____________________________________________________________________

Sr No

Name

Relationship

Age

Marital Status