Form 1-A - Form Of Application For Commutation Of A Fraction Of Superannuation Pension Without Medical Examination Page 3

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PART III
Forwarded to the Accounts Officer.
(here indicate the address and designation)
with the remarks that -
(i)
the particulars furnished by the applicant in Part I have been verified and are correct ;
(ii)
the applicant is eligible to get a fraction of his pension commuted without medical examination ;
(iii)
the commuted value of pension determined with reference to the Table applicable at present comes
to Rs
, and
(iv)
the amount of residuary pension after commutation will be Rs
2.
The pension papers of the applicant completed in all respects were forwarded under this Ministry/
Department/Office Letter No
, dated
It is requested that the payment
of commuted value of pension may be authorized through the Pension Payment Order which may be issued
one month before the retirement of the applicant.
3.
The receipt of Part I of this Form has been acknowledged in Part II which has been
forwarded separately to the applicant on
4.
The commuted value of pension is debitable to Head of Account
Place :
Signature
Date :
Head of Office

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