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Name and Designation

of the Individual:
Date of Birth:
Date of Joining:
CPS Index No.

FORMAT OF APPLICATION FOR SETTING RIGHT THE MISSING CREDIT UNDER CONTRIBUTORY PENSION SCHEME
DDO Code:
DDO Description:
Name of the DistrictTreasury / Sub Treasury

I. SPECIFIED MISSING CREDIT AS GIVEN IN ACCOUNT SLIP 2013-2014

(In the case of missing credits relating to the month and year pertaining to the different DDOs, the month and year of missing credit alone be filled in. The remaining d
concerned for which he should be informed-DDO code and Description to be given in the remarks column)
Sl.No Month and Amount of Missing Credit
Bill Gross
Bill Net
Head of
Token
Token Date
Vr.No.
Date of
Place of
year of
(in Rupees)
Amount
Amount
Account
Number
Encashm Encashmen
Missing
(Debit
ent
t
credit
Head)

Regular
Arrear
Total
Subscriptio Subscriptio
n
n

CHEME

b Treasury

he remaining details will be filled by DDO


Total amount
Head of
of the CPS
Account in
schedule in
which
which the
originally
missing credit
booked
found
(Credit
Head)

Remarks

Name and Designation


of the Individual:
Date of Birth:
Date of Joining:
CPS Index No.

FORMAT OF APPLICATION FOR SETTING RIGHT THE MISSING CREDIT UNDER CONTRIBUTORY PENSION SCHEME
Dr. K. Arumugam
M
DDO Code:
Veterinary Assistant Surgeon
Veterin
DDO Description:
03.06.1979
Name of the DistrictTreasury / Sub Treasury
21.05.2016
7194404
PAO North

II. MISSING CREDITS THAT IS NOT SPECIFIED IN ACCOUNT SLIP 2015-2016

(In the case of missing credits relating to the month and year pertaining to the different DDOs, the month and year of missing credit alone be filled in. The remaining d
concerned for which he should be informed-DDO code and Description to be given in the remarks column)
Sl.N Month and Amount of Missing Credit
Bill Gross
Bill Net
Head of
Token
Token Date
Vr.No.
Date of
Place of
o
year of
(in Rupees)
Amount
Amount
Account
Number
Encashme Encashmen
Missing
(Debit
nt
t
credit
Head)

Regular
Arrear
Total
Subscriptio Subscriptio
n
n
1

May-16

519

519

18186

17321

2403

4994 05.05.15

NA00002

12.05.15

PAO North

Verified the particulars with this office records and found correct and missing amount
may be credited in the individual's account

Verified the particulars with refere


treasury records and found correc

Signature and Seal of the Drawing and Disbursing Officer

Signature and Seal of the Treasury

SCHEME
MC204
Veterinary Surgeon
Treasury

PAO North

The remaining details will be filled by DDO


Total amount
Head of
of the CPS
Account in
schedule in
which
which the
originally
missing credit
booked
found
(Credit
Head)

865 *0318

ars with reference to the


d found correct

of the Treasury Officer

Remarks

CPS in DA
Arrear