Calculation Sheet

Revised Formula Librisation Pensionary Benefit

Sh/Smt ______________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

going to Retire/Retired/Expired on ______________________________.

1. Date of Birth __________________________________________

2. Date of Appointment __________________________________________
3. Total Service from _______________________________________________________
4. Non Qualifying Service __________________________________________
5. Net Qualifying Service __________________________________________
Say __________________________________________
6. Average Emoluments last ten months __________________________________________
i. __________________________________________
ii. __________________________________________
iii. __________________________________________
Total __________________________________________
7. Family Pension Average of Proposed __________________________________________
Pension 50% of Admissible Qualifying Score.
8. For Seven Years 60%, 50%, 30% __________________________________________
9. After Seven Years 60%, 50%, 30% __________________________________________
Total __________________________________________
10. Proposed D.C.H. Gratuity __________________________________________
Last Drawn Payment ___________________ Qualifying Service __________________ Half Years
______________________________________________________________________________
11. Commuted Value __________________________________________
12. Treasury __________________________________________
__________________________________________
13. Address __________________________________________
__________________________________________
 Form of Letter to the Accountant General, Punjab forwarding the
revised pension paper of a Govt. Employee.
Office of the __________________________________________________________________________

_____________________________________________________________________________________

No. _____________________________________ Dated ______________________________________

To

The Accountant General Punjab,

(A&E)

Chandigarh.

Sub: Revised Pension paper of Sh/Smt ___________________________________________________

______________________________________________________________________________

P.P.O. No. _____________________________________________________________.

Sir,

Respectfully, I am directed to forward here with the revised Pension Papers of Sh/Smt. _____________

____________________________________________________________________________________

of this office for sanctioning the revised pension and gratuity.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

So for this case has been sending to you. All the necessary documents attached with the case along with

the service book in ____________ parts.

Thanking you,

Yours faithfully,

P.P.O. No. ______________________________

Permanent Address

_______________________________________

_______________________________________

_______________________________________
 DECLRATION

Declaration to refund the amount of pension and gratuity if paid in excess as referred to in the
9.15 of the Punjab CSR volume II, to be furnished by the retiring officer or a member of his family or his
legal heirs, as the case may be to the Authority sanctioning the pension/service gratuity. Death-cum-
Retirement Gratuity arrears of Pension or Gratuity.

Where the ___________________________________________________________________________

(here state the designation of the officer sanctioning the Pension/Family Pension/Service gratuity/
Death-cum-retirement gratuity/Arrears of Pension or Gratuity) has consented to grant me/us the sum of
Rs. __________________________________________ per month as the amount of my pension/family
pension and/or sum if Rs. ________________________________________________________________
_____________________________________________ Sh/Smt. _________________________________
____________________________________________________________________________________.
(Here give the name and designation of the Govt. Servant)

I/We hereby acknowledge that in accepting this amount I/We fully understand that the
pension/family Pension/gratuity/death-cum-retirement gratuity arrear of pension or gratuity due to
Sh/Smt. _________ _____________________________________________________________________
is subject to revision of being found to be in excess of the amount to which I/we am/are entitled under
the rules and I/we promote to base no objection to me/us in excess of that to which, I/we may be
eventually found entitled.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Attested:

__________________________________________

__________________________________________ Signature

__________________________________________

__________________________________________
 L.P.C. FORM
No __________________________________________
Officer case __________________________________________
Last Pay Certificate of Sh/Smt. ____________________________________________________________
of the ________________________________________________________________________________
To __________________________________________________________________________________
He has been paid upon _________________________ in the grade of ____________________________
PARTICULARS @RATES per month
Substantive Pay __________________________________________
Officiative Pay __________________________________________
Dearness Pay __________________________________________
Dearness Allowance __________________________________________
House Rent/Rural Area Allowance __________________________________________
Compensatory Allowance/
Fixed Medical Allowance __________________________________________
Total __________________________________________
DEDUCTIONS:
General Provident Fund A/G No. Rs _______________________________________ P.M.
Income Tax Rs _______________________________________ P.M.
Postal Life Insurance Policy No. Rs _______________________________________ P.M.
He has made over charge of his duties on the _______________ noon ____________________________
Recovery of advance is to be made from the pay of the Govt. Servant as detailed on the reverse. He has
been paid leave salary as entitled below:
Deductions have been made as noted reverse.
Period Rate per month
From To at Rs. per month
From To at Rs. per month
From To at Rs. per month
He is entitled in draw the following:
Increment secures on ____________________________ every year and this may be drawn in
the absence of instructions to the contrary from the A/General Punjab.
He is entitled to joining time from __________________________________________
The details of the Income Tax recovered from him up the date from the beginning of the current year
noted on the reverse.
Name of Recovery _________________________________________________________________
Installment in which to recovered _____________________________________________________
He will be retire on _________________________________________________________________
From

__________________________________________

__________________________________________

__________________________________________

To

__________________________________________

__________________________________________

__________________________________________

Sub: Application for sanction of revised pension/gratuity and commutation.

Sir,

I wish to say that I have retired from my service with effect from _________________________.
Now I am drawing Pension.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Please revise my pay in the service book and send my revised pension case to the A.G. Punjab
(A&E) Chandigarh for sanction of the revised pension, gratuity and commutation.

Thanking you,

Yours faithfully,

_______________________________________

_______________________________________

_______________________________________

P.P.O. No. ______________________________

Permanent Address

_______________________________________

_______________________________________

_______________________________________