APPLICATION FOR RESTORATION OF COMMUTED VALUE OF PENSION

Officers who have completed 15 years of retirement should fill up the following form and send it to pension disbursing authority for restoration of commuted value of pension.

President, RDOA

9871351203, 9212252627

Application for restoration of commuted value of Pension

To be filled by the pensioner and submitted to the PDA

TS/PS NO………………… 

NAME OF THE BANK      …………………………… 

To 

…………………………….

…………………………….

…………………………….

SUBJECT: RESTORATION OF COMMUTED PORTION OF PENSION AFTER 15 YEARS 

Sir, 

Kindly restore my commuted portion of pension in terms of Ministry of Personnel, PG & Pension, Department of Pension and Pensioners’ Welfare OM No. 34/3/86-P&PW, dated 5^th  March, 1987.  Requisite particulars are given below :- 

1.   Name in Block letters                                   

2.   Date of retirement                                             

3.   PC/PPO No.                                                    

4.   Amount of pension commuted                         

5.   Amount of Original pension                              

6.   Name of the Accounts Officer viz                     

      the authority who issued PC/PPO 

7.   Name of the Treasury/Post Office/DPDO        

      /PPM/ Other Pension Disbursing authority*   

*Strike off whatever is not applicable. 

  

Signatures of Pensioner 

Date:    ……………… 

Postal Address:- 

 ……………………………

…………………………….

…………………………….

   

Particulars verified.

Signature :

Rubber Stamp of Pension Disbursing Authority

  

(Authority : G.O.I., MOD Order No. 1(2)/98/D(PEN/SERS) dated 14/7/98)