PENSION - SINGLE COMPREHENSIVE FORM

                                                        SINGLE COMPREHENSIVE FORM

                                                                    (As per Memo No.359-F(Pen) dt. 16.04.2009)

                      PLEASE FILL IN ALL THE ITEMS PROPERLY AND CAREFULLY. IN CASE A PARTICULAR ITEM IS NOT APPLICABLE, PLEASE STATE SO. BUT DO NOT LEAVE THE ITEM BLANK. THIS FORM NOT COMPLETED IN ALL RESPECTS WILL NOT BE ACCEPTED AND A FRESH SINGLE COMPREHENSIVE FORM MAY BE CALLED FOR.

39. (A). The undersigned having satisfied himself that the above particulars are true and that the service of the Govt. employee has been thoroughly satisfactory hereby orders the grant of the full pension/family pension, death-cum-retirement gratuity which may be accepted by the Accountant General & as admissible under the rules.

Or

(B). The undersigned having satisfied himself that the service of ................................ has not been thoroughly satisfactory here by orders that the full pension/family pension/death-cum-retirement gratuity, which may be accepted by the Accountant General & as admissible under the rules shall be reduced by the specified amount or percentage indicated below :-

Amount of percentage of reduction pension/family pension…………..Amount or percentage of reduction in gratuity………………… The grant of pension/family pension, death-cum-retirement gratuity…..............................……………..

(Inapplicable portion should be scored out)

This order is subject to the condition that if the amount of pension and/or gratuity as authorised be afterwards found to be in excess of amounts to which the pensioner is entitled under the rules, he/she shall remain liable to refund such excess.

                                                                            Signature………………………………..

                                                                                Full Name……………………………………..

                                                                        Designation of the Pension Sanctioning Authority

                                                                                Secretary, Govt. of West Bengal,

                                                                         Judicial Department, Writers’ Buildings,

                                                                                           Kolkata- 700 001.