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Showing posts with label FORMS. Show all posts
Showing posts with label FORMS. Show all posts
29.9.14

Settlement of Deceased Claim Cases

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25.9.14

Forms & Downloads

PENSIONERS FORMS
Pensioners Life CertificateClick here

GPF
GPF Advance FormClick here
GPF Withdrawal FormClick here
GPF Nomination FormClick here
Form for Conversion OF GPF Advance into a Final WithdrawalClick here
GPF Final PaymentClick here

CGHS
Medical Reimbursement Claim FormsClick Here
Application Form for Plastic CardsClick Here
Application Form for CGHS Card for PENSIONERSClick Here
Application Form for CGHS Card for AUTONOMOUS BODIESClick Here

TAX RETURNS FORMS
Form 2F - Return of IncomeClick Here
Form No. 2E SARAL Click Here
Form 2C Click Here
SARAL ITS-2 Click Here
SARAL ITS-3 Click Here

PRAN - PERMANENT RETIREMENT ACCOUNT NUMBER
1.Application for Allotment of Permanent Retirement Account Number (PRAN) (Annexure S1)Click here
2.Request for Activation of Tier-II account under New Pension System (NPS) (Annexure UOS-S10 )Click here
3.Withdrawal form for Tier II account under NPS (AnnexureUOS-S12)Click here
4.Covering Letter with Subscriber Registration Application Form - PAO (Annexure S6)Click here
5.Covering letter for Subscriber Registration Application Form -DDO (Annexure S5)Click here
Courtesy:-cgecorner.com
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5.2.14

Medical Certificates

FORM – 4
(See Rule-19)

Medical Certificate for Non-Gazetted Officer recommended leave or Extension of leave or commutation of leave.








Signature of Government Servant


………………………………   after   careful   personal   examination   of   the   case   hereby

certify that Shri / Smti / Kumari…………………………………………………………

whose signature  is given above  is suffering  from…………………………………….and I

consider  that  a  period  of  absence  from  duty  of  ………………………………………..

days   with   effect   from…………………………………is   absolutely   necessary   for   the

restoration of his / her health.






Date………………………..                                         Authorised Medical Attendant



FORM – 5

Medical Certificate of Fitness to Return to duty


Signature of Government Servant


I…………………………………………………..do hereby  certify that I have carefully
examined Sri / Smti / Kumari ………………………………………… whose signature is
given above and find that he/she recovered from his/her illness and is now fit to resume duties in Government Service. I also certify that before arriving at this decision, I have examined the original medical certificate and statement of the case (or certified copies thereof) on which leave was granted or extended and have taken into consideration in arriving at my decision.



Date……………………….                                                                       Authorised Medical Attendant.
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5.2.14

Application for LTC Advance

DEPARTMENT OF POSTS


Application for LTC Advance

1. Name of applicant                                                               :                                                          

2. Designation & Office                                                           :

3. Whether permanent or temporary (if temporary surety
    Bond from a permanent Govt. servant other than a
    Member of Gr ‘D’ staff should be attached                           :

4. Date of appointment                                                             :

5. Basic pay                                                                             :

6. i) Home Town as recorded in the service book.
 
  ii) Place to be visited ( anywhere in India)                             :

7. Nearest Railway station (write in capital letters)                   :

8. Instance between place of duty and the HOME TOWN /
    Place to be visited as shown in col.5 of above                       :

9. Whether the applicant has completed / will complete one
    One year of service on the date of commencement of
     Journey                                                                              :

10. Two year / Four year block for which the LTC is desired
      To be availed of ( Block year may be given                          :

11. Nature and period of leave                                                   :
           
12. Particulars of persons who are to avail of LTC                      :
Sl No
Name of Person
Age
Relationship with the Govt. servant



























13. Total No. of tickets / ticket                                               :

14. Date of commencement of the onward journey                  :

15. Whether intention to avail of the LTC has been intimated
      Formally in advance, if not necessary formal intimation
      May please be given now.                                                 :

16. How is the journey to the place to be visited to be
      Undertaken by the officer/ official (is) whether by Rail,
      Road or both.                                                                     :
17. Amount of the advance required ( Breai-up) of the
     Advance required                                                                :
i)                    cost of single fare for outward journey only by rail or road
ii)                  cost of the outward journey for all persons               :

       iii)          cost of the return journey for all persons                :

      iv)        Total amount of OUTWARE & RETURN journeys :

       v)           LTC advance admissible (only 80% of 17 (iv)        :

18. Whether LTC was availed during the previous block of four years:

19. Whether final bill in respect of the previous LTC advance has
      Been submitted and since passed                                         :

20. i) I hereby affirm that all the particulars furnished are true to the
         Best of my knowledge and belief                                       :

ii)I certify that my son(s)/ daughter(s)/ Father/ mother/ brother(s)
   sister(s) mentioned above are residing with and wholly
   dependent on me.

iii)I undertake to refund in ONE LUMP the LTC advance granted
    to me in case outward journey is not commenced within 60
    day of the grant of the advance.

iv)I undertake to produce the cash receipts or full details of the
      cash receipts for the outward journey with in 10 days from
      the date of grant of  advance.                                        :

v) I undertake to submit the TA bill for the journeys performed
    WITHIN A MONTH of the completion of the return journey
    Along with necessary cash receipts for both the onward return
    Journeys.

vi) In case any part of whole amount of the advance now granted
     become recoverable form me, I undertake to refund the entire           
     FORTH WITH IN ONE LUMP.

vii) I also undertake to pay penal interest on the outstanding
      advance.

viii) I undertake to enclose necessary prave for having reached the
       declared place of visit and the particulars of tickets for the
       return journey with my TA bill to be submitted later.


Place:                                                                                             Signature of the official

Date:                                                                                              Designation:

…………………………………………………………………………………………………………. 
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5.2.14

CERTIFICATES TO BE GIVEN BY THE GOVERNMENT SERVANT ON LTC

CERTIFICATES TO BE GIVEN BY THE
GOVERNMENT SERVANT ON LTC

            1. I have not submitted any other claim so far for Leave Travel Concession in respect of my self or my family members in respect of the block of the years ________   and __________         

            2. I have already drawn T.A. for the Leave Travel Concession in respect of a journey performed by me/my wife with _________________ children.  This claim is in respect of the journey performed by my wife/myself with _____________    children none of whom traveled with the party on the earlier occasion.

            3. I have not already drawn T.A. for the Leave Travel Concession in respect of a journey performed by me/my wife with  ___________     children/  _________   children in respect of the block of two years  ___________       and  __________  . This claim is in respect of the journey performed by my wife/myself with _________                    children/  ___________  children none of whom availed of the concession relating to that block.

            4. I have already drawn T.A. for the Leave Travel Concession in respect of a journey performed by me in the year, ____________ in respect of block of two years __________and __________  This claim is in respect of the journey performed by me in the       year ___________ This is against the concession admissible once every year in a prescribed block for visiting hometown as all the members of my family are living away from my place of work.

            5. The journey has been performed by me/my wife with ___________ children/ ___________ children to the declared home town viz. ____________

            6. That my husband/wife is not employed in Government service       
                That my husband/wife is employed in Government service
and the concession has not been availed of my him/her separately for himself/herself or for any of the family member for the concerned block of two years.

            7. Certified that my wife/husband for whom L.T.C. is claimed by me is employed in
   ______________ ( name of the Public Sector Undertaking/Corporation/ Autonomous body etc.) which provides Leave Travel Concession facilities but he/she has not preferred and will not prefer, any claim in this behalf to his/her employer.                                            

            8. Certified that my wife/husband for whom L.T.C. is claimed by me is not employed in any Public Sector Undertaking/Corporation/Autonomous Body financed wholly or partly by the Central Government or a Local Body, which provides L.T.C facilities to its employees and their families.


Station:                                              
Date:                                                                               
 Signature of the Government servant.
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5.2.14

Download All DO-HO-SO-BO-PLI-RPLI Forms

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5.2.14

Important Forms - Tamilnadu Govt Employees

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