Modification of Central Government Pensioners life certificate Format for Revised Life Certificate – Modification in Life Certificate (Annexure XVII)

Personnel Ministry has published correction slip-24 for Modification in Life Certificate (Annexure XVII)

GOVERNMENT OF INDIA

MINISTRY OF FINANCE

DEPARTMENT OF EXPENDITURE

CENTRAL PENSION ACCOUNTING OFFICE

TRIKOOT-Il, BHIKAJI CAMA PLACE.

NEW DELHI-110066

CPAO/Tech/Amdt.-Sch. Book/2015-16/1655

dated: 12.10.2015

Amendment to the Scheme for Payment of Pensions to Central Government Civil Pensioners by Authorized Banks [Fourth Edition, 3rd December, 2004)

Correction Slip-24

Modification in Life Certificate (Annexure-XVII)

ANNEXURE-XVII (See para 15.1 page 11 of CPAO’s Scheme Booklet) Part-A (Every year) LIFE CERTIFICATE (To be submitted by Pensioner once a year in November) Certified that I have seen the pensioner Shri/Smt./Ms. ___________________________________ (Name of Pensioner) holder of Pension Payment Order No. _________________________ and that he/she is alive on this date. 1. Present address of the pensioner/ family pensioner. 2. Telephone/Mobile number (if any). 3. E-mail Address (if any). Name Place: Designation of Authorised Officer Date: . Seal ACKNOWLEDGEMENT            Life Certificate of Pensioner/Family Pensioner of Shri/Smt/Ms._______ _____________ _________ _________ (Name of Pensioner) holder of Pension Payment Order No.___________________ has been received. Date:- Signature………………….. Name Stamp of the receiving Bank branch

(Vijay Singh)

Sr. Accounts Officer (Tech)

CGA’S Authority No. 1(7) CPAO SCI]. Book (1)/4-th Edition/2005/TA-III/566 dated-9th October, 2015.