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D.A % 24.

824 HRA
GIS 60 APGLI
CCA 0 HMA 75 PP 95 FPI
STO
45 Years
Date of Retirement
Scale
Designation
Fathers/Husband Name
Permanent Address
Date of Birth
EMPLOYEE PAY PARTICULARS
Name of the Pension Disbursing Authority Jogipet
Sri.B.Narsimlu
Village: Tekmal
Post & Mandal Telkmal
Dist:Medak,502302
SBH
PS.Salojipally Post Held in
Basic Pay
Sri.B.Narsimlu Name of the Government Servant
B.Bagaiah
PENSIONERS SOFTWARE
SGT
www.prtumedak.org
Date of entering in to Serice
Sri.B.Narsimlu
Village: Tekmal
Post & Mandal Telkmal
Dist:Medak,502302
Address After Retirement
123456465
Jogipet
Account. No
NOMINEE DETAILS
Name of the Naominee Smt.Durgamma
Name of the Paying Bank
Relation ship with Govt Servant
Age
Branch Name
Wife
Date of Birth Relationship
Married/
Un-married
07.05.1965 WIFE Married
20.02.1989 SON Un-Married
04.05.1994 SON Un-Married
. . .
. . .
www.prtumedak.org
.
Office Address
The Mandal Educational Officer,
M.P.Tekmal,
Dist.Medak
.
. .
Manoj Kumar
Mahesh Kumar
Name of the Member
whether Employee or
not
Smt. Durgamma Yes
Not
Not
2. A mole on the righ Ear
OFFICE DETAILS
FAMILY MEMBERS DETAILS
Full Amount
Personal Identification Marks 1.Amole on the route of fore finger
Amount of Share payble
0
R.RAMESH
9989663755
EMPLOYEE PAY PARTICULARS
Jogipet
P
R
T
U
M
E
D
A
K
PS.Salojipally
0
30
Sri.B.Narsimlu
B.Bagaiah
PENSIONERS SOFTWARE
www.prtumedak.org
www.prtumedak.org
.
.
whether Employee or
not
Yes
Not
Not
P
R
T
U
M
E
D
A
K
2. A mole on the righ Ear
OFFICE DETAILS
FAMILY MEMBERS DETAILS
1.Amole on the route of fore finger
Lr. No Date :
From To
THE ACCOUNTANT GENERAL ( A&E )
Audit Officer,LFA,Hyderabd
Andhrparadesh.
Sir,

Proposals Submitted.
Iam to forward herewith the Service / Family Pension Papers of
Who is due to retire / retired /expired while in service on
The follwing documents are forwarded herewith for autorising Pensionery Benefits.
1. Part - I :
2. Part - II :
3. Part - II B :
4. Annexure - I :
5. Annexure -II :
6. Copy of Annexure - III :
7. Service Register of Govt.Servant. :
8. L.P.C :
9. Death Certificate (in case of Death) :
10. Legal heir Certificate (- do-) :
11
12

The receipt of above document may please be ackonwledge and arrangements may ne made to
issue the PPO / Gratuity Payment Order and Commutation authorisation early.
No.of enclosures ( )

1. Copy to Sri.B.Narsimlu,SGT
2. Copy to The Office File.
Prepared by R.Ramesh,Tekmal,Medak. 9989663755.www.prtumedak.org
Sanction Order of Pensionary Benefits.
Descriptive Roll
Nomination
Your's Faithfully
Information furnished by the Govt.Servant/Family Pension
Information filled in by the Pension Sanctioning Authority
Beeficiery
Ref : G.O.Ms.No 262 Fin & Plg. (FW-PSC ) Dept.Dt. 23-11-1998
G.O Ms.No 263 Fin & P;g. (FW-PSC ) Dept.Dt. 23-11-1998
Sub : Pension / Service Pension / Family Pension and other Retiring Benefits in respect of
(G.O.Ms.No.263 Dated 23-11-1998)
The Mandal Educational Officer,
M.P.Tekmal,
Dist.Medak
PENSION FORWARDING LETTER
Prepared by R.Ramesh,Tekmal,Medak. 9989663755.www.prtumedak.org
Sanction Order of Pensionary Benefits.
Descriptive Roll
Nomination
Your's Faithfully
Information furnished by the Govt.Servant/Family Pension
Information filled in by the Pension Sanctioning Authority
Ref : G.O.Ms.No 262 Fin & Plg. (FW-PSC ) Dept.Dt. 23-11-1998
G.O Ms.No 263 Fin & P;g. (FW-PSC ) Dept.Dt. 23-11-1998
Sub : Pension / Service Pension / Family Pension and other Retiring Benefits in respect of
(G.O.Ms.No.263 Dated 23-11-1998)
(a) (d)
Sl.N
o
Date of birth
Relationship
with
government
servant
Married or
unmarried
1 07.05.1965 WIFE Married
2 20.02.1989 SON Un-Married
3 04.05.1994 SON Un-Married
4 . . .
5 . . .
4. Address after retiremnt Sri.B.Narsimlu
Village: Tekmal
Post & Mandal Telkmal
Dist:Medak,502302
2. Name of the Applicant
(in case of death of government servant)
3. In case of death while service of Government servant,at the answer 'Married' in case of daughter
will be understood that the daughter is alteady married as on the date of death of the Government
servan
Sri.B.Narsimlu
FORM OF APPLICATION FOR SERVICE PENSION/FAMILY PENSION/
RETIREMENT GRATUITY/SERVICE GRATUITY/COMMUTATION
(To be furnished in duplicate)
G.O.MS No 623,Dated :23.11.1998
Part -I Information to be furnished by the Government Servant/Applicant
(The Pension Sanctioning Autthority shall forward the application duly processed
to the AG(A&E)/LF Authority within a period of 30 days)
1. a) Name of the Government Servant
b) Post held PS.Salojipally
STO,Jogipet
Sri.B.Narsimlu
Village: Tekmal
Post & Mandal Telkmal
Dist:Medak,502302
3. Permanent Address
5. Commutation of Pension
Yes
a) Whether willing to commute 40% of
monthly pension,subject to AP Civil
Pensions (Commutation) Rules,1944.
7. LIST OF FAMILY MEMBERS
( c ) (b) (e)
fraction less than 40%
6. a) Name of the Pension Disbursing Authority
b) If the answer is NO,specify the
Pension payment is desired by the
pensioner/family pensioner/gratuitant
Name ot the Bank and
Branch
S.B.Account No
123456465
SBH
Jogipet
b) Name of the Paying Bank from where
Mahesh Kumar
Name of the family member
whether employed or not .Give
details of employmment
Smt. Durgamma Yes
.
.
Not
Not
.
.
Instructions :
1. The Government servant is insructed to fill up the proforma cery carefully as the data furnished is vital for
sanction of family pensin.He/She may note that alterations of the data furnished at a later date is not
permissible.
2. The "family for the purpose mean "wife" or "husband" as the case may ne "sons"and "unmarried
daughters" as laid down in Rule 50(12) (for Family Pension) and Rule 46(5) (for gratuty) of AP Revised Pension
Rules,1980.
Manoj Kumar
Prepared by R.Ramesh,Tekmal,Medak. 9989663755.www.prtumedak.org
Sri/Smt --------------------------------------------- is / are under guardianship of
Sri/Smt ---------------------------------------------
1
2
3
Place :
Date : 5/11/2014
Governmnet servant.
1. I Undertake to refund the amount of Pension,Gratuty and Commutaion,if it is found subsequently
to be in execess of the amount to which I was entitled under the Rules.
2. I solemnly affirm that the particulars given by me in Part -I at item 7 are correct and true to the best
of my knowledge.If found false in future,Iam liable for suitable action as may be taken by the
Govermnet.

3. The particulars given above ae correct and true to the best of my knowlege.If found false in future
I may be liable for any action that may ne taken by the Governmnet.
PS.Salojipally
Date : 5/11/2014 Signature of the
Place :
TO BE FILLED IN BY THE HEAD OF THE OFFICE
1. Application for pension/gratuty etc.in Part I isreceived
(Date to be recorded)
2. Certified that the person/persons mentioned by the Government servant/Application in item 7 of
Prepared by R.Ramesh,Tekmal,Medak. 9989663755.www.prtumedak.org
Head of the officer
Signature of the

Part I are legally entitled to receive the pension/share in gratury.


3. Guarianship cerificate : (to be filled in wherever necessary)
This is to certify that the following minors of ht deceased Govermnet servant Late
Date of Birth Name
DECLARATION
Rs 10740/-
From To Till Death
From To
From To
Total
Note: Information with conditions will not be accepted by Pension Authority.Amounts for recovery should be specify and
should be in whole rupees.Absence of information will be understood as no dues for recovery
H) Festival Advance
i) Education Advacne
Total
g) Telephone/Trunk call Charges
j) Computer Advacne
k) Other Government Dues
f) Dues on Account of Government Quarters
b) Enhanced Family Pension
19. Government dues to be recovered in respect
a) House Building Advacne
c) Normal Family Pension
c) Marriage Advance
e) Advance salary on Transfer
d) Advance Leave Salary
11. Net qualifying service (9-10)
12. Weightage,if any
57Years -2Months- 6Days
c) Dies-non
d) Boy service
e) Any other service not qualifying for pension
Nil
Nil Total non-qualifying service (a to e)
Nil
Part II (A) Information to be filled up the Pension Sactioning Authority
Rule 46 Retirement Gratuty
Rule 50 Family Pension
Rule 33 Superanuation Pension (Rule 42)
3. Name of the Applicant
( in case of death of government servant)
Government servant retires/tetired/died
8. The rule applicatble
a) The relevant Rule under the AP Revised
1. Name of the Government Servant and Post held
a) E.O.L
B.Bagaiah
2. Father's Name/Husband's Name
4. Date of Birth of Government servant
5. Date of entering in to service
number(s) applicable and strike out the rest)
6. Date of retitement/death
7. Designation and officer from which the
(B.Px30/100)
B.P: Rs 35800, DA@24.824%= Rs 8887
57 Years 2 Months 6 Days Years
35800x33/66=17900
( 35800+8887) x 66 x 1/4 = Rs 737336
Rs 17900/-
Admissible.Rs700000/-
(B.P x 33/66)
13. Total qualifyilng service for calculation of
pension (11+12)
14. Last pay drawn ( Rule 31,46(4),50 (12)( C ) of
APRPRs,1980) Para 4 of G.O Ms.No 87 Fin & Plg
17. Calculation of Family Pension
16. Calculation of Retirement gratuty ( Rule 46
APRPRs,1980)
15. Calculation of service pension/service Gratuty
(Rule 45 of APRPRs,1980)
1-3-2011 a) Service Pension
a) Enhanced family Pension
b) Normal Family Pension
18. Period of Payment of Pension
Pension Rules.1980 applicable (tick the rule
Sri.B.Narsimlu,SGT
28.2.2011
22.12.1953
58 Years 10.2.1953
Nil
Nil
Nil
Nil
SGT
57Years -2Months- 6Days
b) Motor Car/Cycle Advance
Interest Principal
b) Whether ANTICIPATORY PENSION is being
sancioned in terms of Rule - 51.
b) Suspension period
9. Total service (6-5)
10. Period of non-qualifying service
d) Any other rule applicable
14860-39540 / Rs 35800/-
Nil
Rs 17900/-
Note1
Note2
Note3
.
Note5
Prepared by R.Ramesh,Tekmal,Medak.9989663755.www.prtumedak.org
Heads of Departments are those listed in Appendix-I mentioned in Article 6 of A.P. Financial Code
Volume -I / Subsidary Rule 32(ii) of FR 9.
Rs 17900/-
Rs 10740/-
If there is any likelihood of delay.Anticipatory Pension/Anticipatory Gratuty as per Rule 51 of A.P.
Revised Pension Rules 1980 shall be drawn and paid by the Head of Office to the beneficiary
withour any delay.
Office Seal
a) Enhanced Family Pension
Pensionary benefits including commutation found admissible under the rules may be authorised.
It is verified from the records in my custody and certify that no diciplinary or judicial proceedings
are pending/contemplated against retiring/retired governmnet servant to whom I am the authority
for sanction of Pension.
i) Service Pension
If the Pensionary benefits are not to be releasede Part-II-B(b) shall be struck off.
Signature and Designation of
Pension Sanctioning Authority
This is to be prepared in duplicate by the Pension Sanctioning Authority.One for the record of
Pension Sanctioning Authority and the other one to be sent to Accountant General/Local fund Audit
Officer.
The Pension Sanctioning Authority should satisfy about the correctness of the pariculars of family
furnished by the Government Servant/Appicant in Part-I
(Strike off whichever is not applicable)
b) Normal Family Pension
Rs 17900/-
( 35800+8887) x 66 x 1/4 = Rs 737336
b) Sanction Order :
iv) Family Pension
Admissible.Rs700000/-
ii) Retiring Gratuity
iii) Commutation
(Rs 17900/-x40/100)x12x8.371=Rs 719237/--
ii) Iam the next Gazetted Authority in the heirachy to the Head of the office in this case who is a non
gazzetted officer and hence,I am copetent to accord sanction under the powers delgated Vide G.O.
Ms.No 262,Finance & Planning (FW-PSC) Department dated 23.11.1998
i) I am declaared by the Head of the Department to be the Head of an officer to accord sanction in
this case under the powers delegated Vide G.O.Ms.No.262,Finance & Planning (FW-PSC)
Department dated 23.11.1998
OR
20. LPC is enclosed/LPC will be sent after retirement LPC Enclosed
PART - II (B)
a) Certificate of comentency to accord sanction (appicable in case of sanction of Pesnion to non
gazetted officers including Class - IV employees)
SANCTION OF PENSION
Prepared by R.Ramesh,Tekmal,Medak. 9989663755.www.prtumedak.org

Son/Wife/Daugher of
1
2
3
Wife/Husband/Son/Daughter/Guardian of
1
2
3
(i) Service Pensioner : Sri/Smt/Kum
Prepared by R.Ramesh ,Tekmal,Medak.9989663755.www.prtumedak.org
( Attestation has to be done across the Photos by a Gazetted Officer of AP Government in Service)
B. SPECIMEN SIGNATURE OF :
(I) - Service Pensioner :
(II) Family Pensioner/Gratuitant/Guarian of Minor or Handicapped Child:
C. PERSONAL IDENTIFICATION MARKS OF :
Service Pensioner : Sri/Smt/Kum Sri.B.Narsimlu SGT
1.Amole on the route of fore finger
2. A mole on the righ Ear
ANNEXURE - I
DESCRIPTIVE ROLLS
A. SPACE FOR PHOTOGRAPHS
Service Pensioner/Family
Pensioner/Grauitant/Guardian of
Minor or Handicapped Child.
Joint Photo of Service Pensioner with Family
Pension beneficiary/Guardian with Minor or
Handicapped Child.
Speicimen Signature of Sri.B.Narsimlu
Son/Wife/Daughter of B.Bagaiah
Specimen Signature of Sri/Smt/KumSmt.Durgamma
Wife/Husband/Son/Daughter/Guardian of Sri.B.Narsimlu
(ii) Family Pensioner/Gratuitant/Guardian of Minor or Handicapped Child :
Sri/Smt/Kum Smt.Durgamma
SIGNATURE OF GAZZETTED OFFICER
Ring finger Little finger
LEFT HAND THUMB AND FINGER IMPRESSIONS OF SERVICEPENSIONER/FAMILY
PENSIONER/GRATUITANT/GUARDIAN OF MINOR OR HANDICAPPED CHILD:(TO BE
GIVEN BY THE ILLETERATE OR THOSE UNABLE TO SIGN AND FOR OTHERS IT IS
OPTIONAL)
Details Thumb finger Fore finger Middle finger
Service
Pensioner
Family
Pensioner
Gratuitant
Guardian of
Minor/Handicap
ped Child.
Place
Date
Attested by
Signature
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
Note 3 Copies will be forwarded to Accountant General/Local Fund Audit Officer by
Pension Sanctioning Authority and one will be retained by the Pension Sanctioning
Authority.
Name
Designation
Office Seal:
(Attestaion has to be done by a Gazetted Officer of AP State Government in Service )
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1 2 3 4 5 6
ANNEXURE
NOMINATION
( The Government servant may use separate forms,if he wishes to make different nomination for each
type of payment mentioned below)

I hereby nominate the person/persons mentioned below and confer on him/her/them
the right to receive Life Time Arreas of Pension,Retirement Gratuty that may be sanctioned by
governmet,in the event of my death while in service and right to receive on my death Life Time Arrears of
Pension,Retirement Gratuty,commuted value of pension.Death Relief which having become admissible to
me on retirement which may remain unpaid at my death.
S
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.
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4
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7
This nomination supersedes the nomination by me earlier on------------
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6
NB: The Government Srvant shall draw lines across the blank space below the last entry to
prevent the inserions of any name after he/she has signed.
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
Dated this At PS.Salojipally
Witness:-
1. Signature Name :
and Address
2. Signature Name
and Address
Designation
Office
Date :
Note (1) :
Note (2) :
Note (3) :
Note (4) :
Note (5)
i)
ii)
iii)
iv)
v)
vi) Father
vii) Mother
viii)
ix)
x)
xi)
Husband, in the case of a female Government servant.
Sonns including step sons, posthumous son, and adopted sons (whose personal law permits such
Unmarried daughters including step daughters, posthumous daughters and adapted daughters.
Widowed daughters including step daughters and adopted daughters
Married daughters, and
Children of apre deceased son
including adoptive partents in the case of individuals where whose personal law
Permits adoption
Brothers below the age of 18 years including step brothers.
Unmarried sisters and widowed sisters including step sisters.
Countersigned
Singnature of the Government Servant
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
Signature of Heade of Office/Department:
Name and Designation :
This nomination form is to be submitted by the employees in triplicate, one for use of the
pension sanctioning authority and two copies to be forwarded to the forwarded to the Account
General Local Fund Audit Offices.
Office Seal
The Governmnet servant who has a family may nominate one member or more than one
member of the family as difined in Rule 46(5) of AP Revised Pension Rules, 1980
The Governmnet servant who has a family may nominate one member or more than one
member of the family as difined in Rule 46(5) of AP Revised Pension Rules, 1980
The Government servant may not that the nomination with signature of two witnesses shall only
have the legal validity of a WILL.
For the purpose of Rules 46, 47, 48 and 49 of Revised Pension Rules 1980, family in to a
Government servant means:-
Wife or wives in the case of a male Government servant.
A
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6
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
Husband, in the case of a female Government servant.
Sonns including step sons, posthumous son, and adopted sons (whose personal law permits such
Unmarried daughters including step daughters, posthumous daughters and adapted daughters.
Widowed daughters including step daughters and adopted daughters
Married daughters, and
Children of apre deceased son
including adoptive partents in the case of individuals where whose personal law
Permits adoption
Brothers below the age of 18 years including step brothers.
Unmarried sisters and widowed sisters including step sisters.
Singnature of the Government Servant
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
This nomination form is to be submitted by the employees in triplicate, one for use of the
pension sanctioning authority and two copies to be forwarded to the forwarded to the Account
General Local Fund Audit Offices.
The Governmnet servant who has a family may nominate one member or more than one
member of the family as difined in Rule 46(5) of AP Revised Pension Rules, 1980
The Governmnet servant who has a family may nominate one member or more than one
member of the family as difined in Rule 46(5) of AP Revised Pension Rules, 1980
The Government servant may not that the nomination with signature of two witnesses shall only
have the legal validity of a WILL.
For the purpose of Rules 46, 47, 48 and 49 of Revised Pension Rules 1980, family in to a
Government servant means:-
Wife or wives in the case of a male Government servant.
From
To
THE ACCOUNTANT GENERAL ( A&E )
Audit Officer,LFA,Hyderabd
Andhrparadesh.
Station :
Date :
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
retired on as was forwarded to AGAPLFA on As per the records held by me no disciplinary/judicial priceedings
are pending/contemplated against the above retiring/retired governmnet employee. I request you to verify
whether any such case is pending against the above employee which entials withholding or withdrawing pensin
or part of pension permanently or for specified period as laid down under Rule 9 of RPRs 1980.If so the AG ( A &
E )/Dy.Accountant General (pension ),O/o the AG (A&E) ,AP Hyderabad/Local Fund Officer may be intimated
accordingly by name either by Registered post or through a spoecial messenger within one month from the dae
of issue of this letter for withholing opensionary benefits as contemplated in Govt,Memo / No 33764-
A/55/PSC/93,Finance & Planning ( FW-PSC) Department,dt.15-10-1993 and reiterated in government memo .no
37254/361/A2/Pen-I/98,Finance & Palanning (FW-Pen,1) Department,dt 4-7-1998.Copies of such orders shall
also be sent to to the connection the instructions issued in Para 2,Part-II B of G.O .Ms.No 263,Finance & Planning
( FW-PSC) Department,dt.23-11-1998 may be scruplously followed.

( HEAD OF OFFICE )
ANNEXURE - III
BY REGISTERED POST
( Pension Sanction authority )
I am to inform you that Pension / Family Pension appicable form ofSri.B.NarsimluSGT
Sub: Pension -- Sanction Pension and Other Retiring Benefits in respect of Sri.B.Narsimlu
Designation SGT Regarding.
The Mandal Educational Officer,
M.P.Tekmal,
Dist.Medak
retired on as was forwarded to AGAPLFA on As per the records held by me no disciplinary/judicial priceedings
are pending/contemplated against the above retiring/retired governmnet employee. I request you to verify
whether any such case is pending against the above employee which entials withholding or withdrawing pensin
or part of pension permanently or for specified period as laid down under Rule 9 of RPRs 1980.If so the AG ( A &
E )/Dy.Accountant General (pension ),O/o the AG (A&E) ,AP Hyderabad/Local Fund Officer may be intimated
accordingly by name either by Registered post or through a spoecial messenger within one month from the dae
of issue of this letter for withholing opensionary benefits as contemplated in Govt,Memo / No 33764-
A/55/PSC/93,Finance & Planning ( FW-PSC) Department,dt.15-10-1993 and reiterated in government memo .no
37254/361/A2/Pen-I/98,Finance & Palanning (FW-Pen,1) Department,dt 4-7-1998.Copies of such orders shall
also be sent to to the connection the instructions issued in Para 2,Part-II B of G.O .Ms.No 263,Finance & Planning
( FW-PSC) Department,dt.23-11-1998 may be scruplously followed.

ANNEXURE - III
BY REGISTERED POST
I am to inform you that Pension / Family Pension appicable form ofSri.B.NarsimluSGT
Sub: Pension -- Sanction Pension and Other Retiring Benefits in respect of Sri.B.Narsimlu
Designation SGT Regarding.
: : Rs.60=00
: : Rs.0=00
: : Rs.200=00
: :
: :
: :
: :
HMA : Rs.75=00
OTHERS :
: : Rs.260=00
From To
From To
From To
TOTAL
GIS
APGLIS
PT
PP
TOTAL
Rs.3580=00
Rs.8887=00
--
--
Rs.95=00
Rs.48437=00
Rs.35800=00
CCA
FPI
Scale
Basic Pay
HRA
DA
PARTICULARS
Last pay certificate of Sri.B.NarsimluSGT of the PS.Salojipally proceeding on retirement
due to Superannuation
LAST PAY CERTIFICATE
He /She has been paid up to --------------- at the following rates
DEDUCTIONS
14860-39540
He/She made over charge of the Officer of PS.Salojipallyon the after noon of,28.2.2011
PERIOD RATE
The details of the income-tax recovered from him/her upto the date from the beginning
of the current year are noted on the reverse
He/She is entitled to draw the following
He/She is also entitled to joining time for
Recoveries are to be made from the pay Government Servant as detailed on the reverse
He/She has been paid leave salary as detailed above deduction have been made as
noted on the reverse.
To .. From
AMOUNT
From..
To .. From To. From..
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
To .. From To. From..
To.
Nature of recovery
Amount Rs
To be recovered in I nstalment
From to on account of Rs
From to on account of Rs
From to on account of Rs
Rs Ps Rs Ps Rs Ps Rs Ps
May
June
April
Jan
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
July
Aug
Feb
Mar
Sep
Oct
Nov
Dec
DETAILS OF RECOVERIES
instalment.
Pay
Gratuity Fee etc.
Fund and other
deductions
amount of
Income Tax Remarks
Name of
the month
DEDUCTIONS MADE FROM LEAVES SALARY
1
2
3
Signature
Signature
RESPONSIBILITY CERTIFICATE
I Sri.B.Narsimlu,S/O B.Bagaiah to be retired as SGTO/o ThePS.Salojipally do
here by declare that,if any amount to be excess paid,due to erroneous calculation, noticed
at a later date,I shall be ready to refund the same without any objection in the matter
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
Station
Date
CERTIFICATE UNDER ACT OF 1982
Certified that Sri.B.Narsimlu SGT.Asst was not sanctioned 130-250/150-300
grade under trainedgraduate teacher and no amount is to be recoverable from under act
14 of 1982
LEAVE CERTIFICATE
Certified that Sri.B.Narsimlu, SGT ,PS.Salojipally has not availed any leave / has
availed the following kind of leave during the period.of his/her service
Signature
SUSPENSION CERTIFICATE
Certified that Sri.B.Narsimlu,SGT,PS.Salojipallyhas not been suspended any
time during his/her service
Drawing officer Pensioner Attested
a) The amount has been recovered and recorded in the SB at Page No ( )
b) The amount has been recovered
c) Not Applicable
NO DUES CERTIFICATE
Signature
AUDIT OBJECTIONS CERTIFICATE
Certified that here are no audit objections are pending in respect of Sri.B.NarsimluSGT
Signature
Certified that No Govt dues are recoverable from Sri.B.NarsimluSGTGovt towards the:
1) Sales proceedings of A.P Trading Corporation.
2) Nationalised Text books and note books as they are not supplied/supplied to him
Signature
Prepared by R.Ramesh,Tekmal,Medak,9989663755.www.prtumedak.org
Certified that Sri.B.NarsimluSGT(Arts Graduates) was Sanctioned 130-250/150-300 grade
W.E.F through he /She was untrained graduaes by virtue of Court order / Department order claim
amount is recoverable from him as per act 14 of 1992
RECOVERIES UNDER ACT 14 OF 1992
NO ALLEGATIONS CERTIFICATE
Certified that no allegations are pending
againstSri.B.Narsimlu,(Designation)SGT,PS.Salojipally