FORMS (PART - I)

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RAILWAY SERVICES (PENSION) RULES, 1993

FORMS

PART - I

	FORM OF APPLICATION FOR PERMISSION TO RAILWAY OFFICERS TO ACCEPT COMMERCIAL EMPLOYMENT WITH IN A PERIOD OF TWO YEARS AFTER RETIREMENT.
	SURETY BOND.
	Certificate of verification of Military Service
	NOMINATION FOR DEATH-CUM-RETIREMENT GRATUITY
	NOMINATION FOR RETIREMENT/DEATH GRATUITY
	STATEMENT SHOWING THE DETAILS OF THE MEMBERS OF THE FAMILY FOR PURPOSE OF FAMILY PENSION
	FORM FOR ASSESSING PENSION AND GRATUITY
	PARTICULARS TO BE OBTAINED BY THE HEAD OF OFFICE FROM THE RETIRING RAILWAY SERVANT EIGHT MONTHS BEFORE THE DATE OF HIS RETIREMENT
	FORM OF LETTER TO THE ACCOUNTS OFFICER FORWARDING THE PENSION PAPERS OF A RAILWAY SERVANT
	FORM OF APPLICATION FOR THE GRANT OF FAMILY PENSION 1964 ON THE DEATH OF A RAILWAY SERVANT/PENSIONER
	FORM OF LETTER TO THE MEMBER OR MEMBERS OF THE FAMILY OF THE FAMILY OF A DECEASED RAILWAY SERVANT WHERE VALID NOMINATION FOR THE GRANT OF THE DEATH GRATUITY EXISTS
	FORM OF LETTER TO THE MEMBERS OF THE FAMILY OF A DECEASED RAILWAY SERVANT WHERE VALID NOMINATION FOR THE GRANT OF DEATH GRATUITY DOES NOT EXIST
	FORM OF APPLICATION FOR THE GRANT OF DEATH GRATUITY ON DEATH OF A RAILWAY SERVANT
	FORM OF LETTER TO THE WIDOW/ WIDOWER OF A DECEASED RAILWAY SERVANT FOR GRANT OF FAMILY PENSION 1964
	FORM OF CERTIFICATE OF VERIFICATION OF SERVICE FOR PENSION
	FORM FOR ASSESSING AND AUTHORISING THE PAYMENT OF FAMILY PENSION AND DEATH CUM-RETIREMENT GRATUITY WHEN A RAILWAY SERVANT DIES WHILE IN SERVICE
	FORM OF LETTER TO THE ACCOUNTS OFFICER FORWARDING PAPERS FOR THE GRANT OF FAMILY PENSION AND DEATH-CUM-RETIREMENT GRATUITY TO THE FAMILY OF A RAILWAY SERVANT WHO DIES WHILE IN SERVICE.
	FORM OF LETTER SANCTIONING FAMILY PENSION 1964 TO THE CHILD OR CHILDREN OF A RETIRED RAILWAY SERVANT WHO DIES AFTER RETIREMENT BUT DOES NOT LEAVE BEHIND A WIDOW OR WIDOWER
FORM OF LETTER SANCTIONING FAMILY PENSION TO THE CHILD OR CHILDREN ON THE DEATH OR RE-MARRIAGE OF A WIDOW/WIDOWER WHO WAS IN RECEIPT OF FAMILY PENSION
	1964.
	Form of application for the Grant of Residuary * Gratuity on the Death of a Pensioner.

 

FORM 1

(See Rule 11)

FORM OF APPLICATION FOR PERMISSION TO RAILWAY OFFICERS TO ACCEPT COMMERCIAL EMPLOYMENT WITH IN A PERIOD OF TWO YEARS AFTER RETIREMENT.

1.	Name of the Officer (in BLOCK letters)			_________________________________
2.	Date of retirement			_________________________________
3.	Particulars of the Ministry/Department/ Offices in which the Officer served during the last five years preceding retirement (with duration)
	Name of Ministry/Department/Office			Post held	Duration
					Form	To
	(i)
	(ii)
4.	Post held at the time of retirement and period for which held			_________________________________
5.	Pay scale of the post and the pay drawn by the Officer at the time of retirement			_________________________________
6.	Pensionary benefits
	Pension expected/sanctioned (Communication) if any, should be mentioned			Gratuity, if any
7.	Details regarding commercial employment proposed to be taken up:-
	(a)	Name of the firm / company / Co-operative society, etc.		_________________________________
	(b)	Products being manufactured by the firm/ type of business carried out by the firm, etc.		_________________________________
	(c)	Whether the officer had during his official career, any dealing with the firm, etc.		_________________________________
	(d)	Duration and nature of the official dealings with the firm, etc.		_________________________________
	(e)	Name of the job/post offered		_________________________________
	(f)	Whether post was advertised, if not, how was offer  made (attach newspaper cutting of the advertisement, and a copy of the offer of the appointment, if any)		_________________________________
	(g)	Description of the duties of the job/post		_________________________________
	(h)	Remuneration offered for post/job		_________________________________
	(i)	If proposing to set up a practice, indicate:		_________________________________
		(a)	Professional qualification/in the field of practice	_________________________________
		(b)	nature of proposed practice	_________________________________
8.	Any information which the applicant desires to furnish in support of his request			_________________________________
9.	Declaration:

 I hereby declare that                                

1. the employment which I propose to take up will not bring me into conflict with Government;
2. my commercial duties will not be such that my previous official position or knowledge or experience under Government could be used to give my proposed employer an unfair advantage;
3. my commercial duties will not involve liaison or contract with the Government departments.

Place ..		Signature of the applicant
Date, the .		Address:

 

FORM 2

(See Rule 15)

SURETY BOND

In consideration of the President of India (hereinafter called the "Government" which expression shall include his Successors and assignees) having agreed to settle the final accounts of Shri/Shrimati …………………. (hereinafter referred to as the 'Obliger') without production of a 'No Demand Certificate' from the Engineering/ Electrical Department concerned, I hereby declare myself 'Surety' (which expression shall include my heirs, executors, Administrators, legal representatives and assignees) for the obliger and do hereby guarantee for due payment of rent, electric current and other dues in respect of the residence now allotted to him/her by Government and also for any residence that may be allotted or that was allotted to the said obliger from time to time by Government against all loss damage until delivery of vacant possession of the above-said residence is made over to the Government.

I hereby also guarantee that the said obliger shall pay all amounts that may be due by him/her to Government by way of overpayment of pay, allowances, leave salary, advances for conveyances, house building or other purposes or for any amounts which may be paid or payable by Government under or in respect of any guarantee given by Government on behalf of the said obliger, or any other dues whatsoever of the Government. It is hereby declared by me that if the said obliger shall die or become insolvent, the whole of the aforesaid amount shall then remain unpaid and the interest, if any, as per the Government Rule applicable thereon, shall immediately become due and payable to the Government and recoverable from me by virtue of this Bond. Now the condition of the above written Bond is that if the said obliger duly makes all payments or caused to be paid to the Government each of the aforesaid amounts owing to the Government to the satisfaction of the Government then this Bond shall be void otherwise the same shall be and remain in full force, effect and virtue.

The obligation undertaken by me shall not be discharged or in any way affected by any extension of time or any other indulgence granted by the Government to the said obliger and the Government shall have the fullest liberty without affecting the guarantee to postpone for any time from time to time any of the powers exercised by it against the said obliger and I will not released from the liability under this guarantee by an exercise of the Government of the liberty with reference to the matters aforesaid or by reason of any other forbearance, act or omission on the part of the Government or any indulgence by the Government to the said obliger or by any other matter or things whatsoever which under the law relating to sureties shall, but for this provision have the effect of  so releasing me from my such aforesaid liability and for the purpose of enforcement this present my liability hereunder will be not merely as surety but as of principal debtor.

BUT SO NEVERTHELESS this Bond shall remain in force, till

1. the 'No Demand Certificate' is issued by the Engineering / Electrical Department concerned in favour of the said obliger.
2. the Head of Office in which the said obliger was last employed has certified that nothing is now due to the Government from the said obliger; and
3. the 'No Demand Certificate' is issued by the Engineering / Electrical Department concerned in favour of the said obliger in respect of water and electricity dues in case Government had given a guarantee for these dues, on behalf of the said obliger.

The stamp duty on this instrument shall be borne by the Government.

 

 

Signed and delivered by the said surety at		Signature of the Surety
this day of ...............
in the presence of :
Signature
Address and occupation of witness
Signature
Address and occupation of witness
Certified that Shri/Shrimati ... is a permanent Government servant.
The above bond is accepted.
		Signature of the Head of the Department of the Office in which the surety is employed.
		(Signature and designation)
		for and on behalf of the President of India

 

FORM 3

(See Rule 35)

Certificate of verification of Military Service of No. ……… …… …….. ......... ....... .. . .... Rank …………………………

Name.............................……………………….Unit…………………………….re-enrolled in the ………………………………………… from……………………….

The information required for verification of War/Military service for the purpose of counting towards railway pension is given as under: -