PENSION SOFTWARE FOR STATE GOVERNM

PERSONAL DETAILS
Name of the Government Employee

Sri. Ranga Devandam

Name of the D.D.O

Father's/Husband's Name

Sri. Ranga Sadanandam

D.D.O. Designation

Designation

Superintendent

D.D.O. Place of wo

Place of working

O/o the District Ednl Officer

Name of the Manda

Name of the Mandal

Nampally

Name of the Distric

Name of the District

Hyderabad

Name of Pension D

Date of Birth

Date of Entering in to Service

November
11

1953
2

Employee Name of

13
13

March
3

1990
39

Employee Bank Acc

Date of Retirement

25
25

November
11

2011
60

Permanent Address

H. No. 13-11-245/A/16/2/B, Tallagadda,

Karwan, Hyderabad. PIN-500055

Name of the Nomin

Relationship with th
H. No. 13-11-245/A/16/2/B, Tallagadda,
Karwan, Hyderabad. PIN-500055

Address after retirement

Personal Identification Marks

1. A mole on the left side of the stomache.

2. A mole on the right hand.

Date of Submitting Proposal

07-11-2012

Place where proposal submitted

Hyderabad

Amount of Share P

Applicat

Part II

SALARY DETAILS
PAY PARTICULARS

Age of the Nomine

Part II
DEDUCTIONS

Scale of Pay

17
14860-39540

A.P.G.L.I.S.

Basic Pay

18
10900

G.I.S.

2
30
5
150

Developed B

200

K. Sreenivas
District.
1. If any mis
rectify the
ksr_0708@ya
3. Fill the dat
4. Verify with

Spl. Pay/P.P

125

Proffessional Tax

D.A. Percentage

24.824

Others if any

HRA Percentage

20
3

Additional HRA

Applicable
1

C.C.A.

130
4

S.C.A.

160
6

Others if any

450

Annexu

500

DETAILS OF THE FAMILY MEMB

Sl No.
1

Name of the Family Member

Sri. R. Ramana

Date of Birth
15-07-1978

Relationship wit
Employee
Son

STATE GOVERNMENT EMPLOYEES

D.D.O. & OTHER DETAILS
Name of the D.D.O.

Sri. B. Venkateswarlu, B.Sc., B.Ed.

D.D.O. Designation

Gaz. Head Master Gr-II

D.D.O. Place of working

Govt. High School, Malakpet

Name of the Mandal

Saidabad

Name of the District

Hyderabad

Name of Pension Disbursing Authority

P.A.O., Hyderabad

Employee Name of Bank with Branch

S.B.I., Malakpet Branch

Employee Bank Account Number

102356789145

NOMINEE DETAILS
Name of the Nominee

Smt. R. Lingavathy

Relationship with the Employee

Wife

Age of the Nominee

55

Amount of Share Payable

Full Amount

Years

CLICK ON THE FOLLOWING LINKS FOR PRINTS

Application

Annexure II

No Dues

Part II A

Annexure III

Letter to AG

Part II B

L.P.C.

DDO Procs

Annexure I

Appendix

Iden Marks

Developed By:
K. Sreenivas Reddy working at O/o the District Educational Officer, Hyderabad
District.
1. If any mistakes found in this software please give your valuable suggestions to
rectify the mistakes. Send your valuable suggestions to the Mail Id:
ksr_0708@yahoo.co.in.
3. Fill the data in pink coloured cells only.
4. Verify with experts before the submission of your bills.

THE FAMILY MEMBERS

Relationship with
Employee
Son

Married/ Unmarried
Married

Whether Employee or not. Give details of

Employment
Yes, Junior Assistant

FORM OF APPLICATION FOR SERVICE PENSION / FAMILY PENSION / RETIREMENT GRATUITY

GRATUITY / COMMUTATION
(To be furnished in Duplicate)
G.O.Ms.No. 100 Fin (Pension.I), dt: 06-04-2010
G.O.Ms.No. 101 Fin (Pension.I), dt: 06-04-2010
PART - I
Information to be furnished by Government Servant / Applicant

(The Pension Sanctioning Authority shall forward the application duly processing to the AG (A&E) / L.F. Authority wi

(As per Govt. Circular Memo No. 13910/90/A1/PSC/04 Fin (PSC) Dept., dt: 21-06-2004)

1. a) Name of the Government Servant

2.

SRI. RANGA DEVANDAM

b) Post held

Superintendent

Name of the Applicant

(In case of death of Govt. Servant)

DOES NOT ARISE

3. Permanent Address

H. No. 13-11-245/A/16/2/B, Tallagadda, Kar

Hyderabad. PIN-500055

4. Address after Retirement

H. No. 13-11-245/A/16/2/B, Tallagadda, Kar

Hyderabad. PIN-500055

5. Commutation of Pension
a) Whether willing to commute 40% of monthly
pension,
subject
to
A.P.
Civil
Pensions
(Commutation) Rules, 1944
If the answer is NO, specify the fraction less than
b) 40% (As per G.O.Ms.No. 158, dt: 16-09-1999)

6. a) Name of the Pension Dusbursing Authority

Name of the paying bank from where pension
b) payment is desired by the Pensioner / Family
Pensioner / Gratuitan Pensioner / Gratuitant

YES/

NO

Willing to Commute 40%

-------

P.A.O., Hyderabad

Name of the Bank &

Branch

S.B. Accoun

Name of the paying bank from where pension

payment is desired by the Pensioner / Family
Pensioner / Gratuitan Pensioner / Gratuitant

S.B.I., Malakpet Branch

102356789145

7. LIST OF FAMILY MEMBERS

(a)

(e) Marital/Employment status of the

applicant/ deceased Governmen

(b)

(d)

Sl
No.

Name of the Family

Member

Date of Birth

Relationship
with Govt.
Servant

Married or Unmarried.
Date of marriage if
married

Sri. R. Ramana

15-07-1978

Son

Married

Whether Em
Give details

Yes, Jun

Instructions:
1.

The Government Servant is instructed to fillup the proforma very carefully as the data furnished is vital for sanction of family
may note that, alterations of the data furnished at a later date is not pemissible.

2.

The family for the purpose mean "wife" or "husband" as the case may be, "sons" and "unmarried daughters" as laid down in
family pension) and Rule 46(5) (for gratuity) of A.P. Revised Pension Rules, 1980.

3.

In case of death while in service of Government Servant, the answer "Married" in case of daughter will be understood tha
already married as on the date of death of the Government Servant.

DECLARATION
1.

I undertake to refund the amount of Pension, Gratuity and Commutation, if it is found subsequenty to be in excess of the a
was entitled under the rules.

2.

I solemnly affirm that, the particulars given by men in Part-I at item 7 are correct and true to the best of my knowledge
future, I am liable for suitable action as may be taken by the Government.

3.

The particulars given above are correct and true to be best of my knowledge. If found false in future I may be liable for any a
taken by the Government.

Place:

07-11-2012

Date:

Hyderabad

Signature of Govt. Servant/Appli

(SRI. RANGA DEVANDAM)
Superintendent
O/o the District Ednl Officer
Nampally Mandal

TO BE FILLED IN BY THE HEAD OF THE OFFICE

1. Application for Pension / Gratuity etc. in Part-I is received on
(date to be recorded)

2. Certified that the person/persons mentioned by the Government Servant / Applicant in item 7 of Pa
entitled to receive the Pension/ share of Gratuity
3. Guardianship Certificate (To be filled in whereever necessary)

This is to certify that, the following minors of the deceased Government Servant L
____________________________ is/are under the guardianship of Sri./Smt. __________________
Sl. No.

Name

Date of Birth

Does Not Arise

Place:
Date:

07-11-2012
Hyderabad

Signature of the Head of the

Office Seal

SION / FAMILY PENSION / RETIREMENT GRATUITY / SERVICE

ATUITY / COMMUTATION
be furnished in Duplicate)

100 Fin (Pension.I), dt: 06-04-2010

101 Fin (Pension.I), dt: 06-04-2010

PART - I
rnished by Government Servant / Applicant

e application duly processing to the AG (A&E) / L.F. Authority with in 30 days)

13910/90/A1/PSC/04 Fin (PSC) Dept., dt: 21-06-2004)

SRI. RANGA DEVANDAM

Superintendent
DOES NOT ARISE
H. No. 13-11-245/A/16/2/B, Tallagadda, Karwan,
Hyderabad. PIN-500055

H. No. 13-11-245/A/16/2/B, Tallagadda, Karwan,

Hyderabad. PIN-500055

Willing to Commute 40%

-------

P.A.O., Hyderabad

S.B. Account Number

102356789145

(e) Marital/Employment status of the children of the

applicant/ deceased Government Servant

Whether Employed or not.

Give details of Employment
Yes, Junior Assistant

orma very carefully as the data furnished is vital for sanction of family pension. He/she
er date is not pemissible.

as the case may be, "sons" and "unmarried daughters" as laid down in Rule 50(12) (for
vised Pension Rules, 1980.

ant, the answer "Married" in case of daughter will be understood that the daughter is
ment Servant.

DECLARATION
and Commutation, if it is found subsequenty to be in excess of the amount to which I

n Part-I at item 7 are correct and true to the best of my knowledge. If found false in
y the Government.

best of my knowledge. If found false in future I may be liable for any action that may be

Signature of Govt. Servant/Applicant

(SRI. RANGA DEVANDAM)
Superintendent
O/o the District Ednl Officer
Nampally Mandal

D IN BY THE HEAD OF THE OFFICE

d by the Government Servant / Applicant in item 7 of Part-I are legally

tuity

llowing minors of the deceased Government Servant Late. Sri./Smt.

nder the guardianship of Sri./Smt. ____________________________.
Date of Birth

Signature of the Head of the Office

PART - II (A) : Information to be filled up by the Pension Sanctioning Authority

1.

Name of the Government Servant & Post Held

SRI. RANGA DEVANDAM,

Superintendent

2.

Father's / Husband's Name

Sri. Ranga Sadanandam

3.

Name of the Applicant (In case of death of Government

Servant)

------

4.

Date of Birth of the Govt. Servant

08-11-1953

5.

Date of entering in to service

13-03-1990

6.

Date of Retirement / Death

25-11-2011

7.

Designation & Office from where the Govt. Servant

retires/retired/died

Superintendent,

O/o the District Ednl Officer,

Nampally Ma
Hyderabad District.

8.

The Rule Applicable:

a) The relevant rule under the A.P. Revised Pension
Rules, 1980 applicable (tick the rule numbers applicable
and strike out the rest)

Rule 33 Superannuation Pension (Rule 42)

Rule 34 Retiring Pension (Rule 43/44)
Rule 35 Pension on absorption under a Corporation
Rule 37 Invalid Pension
Rule 38 Compensation Pension
Rule 39 Compulsory Retirement Pension
Rule 40 Compassionate Retirement Pension

Rule 43 Retirement on completion of 20 years of qualifying serv

Rule 44 Retirement on completion of 33 years of qualifying serv

Rule 46 Retirement Gratuity
Rule 50 Family Pension

b) Whether ANTICIPATORY PENSION is being santioned

in terms of Rule 51?

YES / NO

c) Whether PROVISIONAL PENSION is being sanctioned

in terms of Rule 9(4) read with Rule 52?

YES / NO

d) Any other Rule Applicable

------

9.

TOTAL SERVICE (6 - 5)

21 Years - 8 Months - 14 Days

10.

Period of Non-Qualifying Service

a) E.O.L. (exceeding 3 years)

NIL

b) Suspension Period

NIL

c) Dies - Non

NIL

d) Boy Service

NIL

e) Any other service not qualifying for pension

NIL

Total Non-Qualifying Service

NIL

11.

Net Qualifying Service (9-10)

21 Years - 8 Months - 14 Days

12.

Weightage, if any

5 Years

13.

Total Qualifying Service for caleculating pension

(11 + 12)

26 Years - 8 Months - 14 Days

14.

15.

16.

Last Pay Drawn (Rule 31, 46(4), 50(12) of APRPRs,

1980) Para 4 of G.O. Ms. No. 87 Fin & Plg (FW-Pen.I)
Dept. dt: 25-05-1998
Caleculation of Service Pension / Service Gratuity
(Rule 45 of APRPRs, 1980)
Caleculation of Retirement / Death Gratuity (Rule 46 of
APRPRs, 1980) and G.O.Ms. No. 14 Fin & Plg (FW-Pen.I)
Dept. dt: 30-01-1999)

Rs. 14860-39540
Rs. 10900

10900 X (26.5 / 66)

= Rs. 4377 /-

B.P: Rs. 10900/- X D.A. @ 24.824% = Rs. 2706/(Rs.10900+Rs.2706) X 53 X 1/4 = Rs. 180280/-

17.

18.

19.

Caleculation of Family Pension

As applicable to the case under consideration

a)

Enhanced Family Pension

N.A.

b)

Norman Family Pension

N.A.

Period of Payment of Pension

As applicable to the case under consideration

a)

Service Pension

#VALUE!

b)

Enhanced Family Pension

N.A.

c)

Norman Family Pension

N.A.

Government dues to be recovered in respect of

Principal

Interest

To

a) House Building Advance

b) Motor Car / Cycle Advance
c) Marriage Advance
d) Advance Leave Salary
e) Advance Salary on Transfer
f) Dues on Account of Govt. Quarters
g) Telephone/Trunk Call Charges
h) Festival Advance
i) Education Advance
j) Computer Advance
k) Other Government Dues

TOTAL
Note:

20.

Information with conditions will not be accepted by Pension Issuing Authority. Amounts for recovery should be
and should be in whole rupees. Absence of information will be understood as no dues for recovery.

L.P.C. Enclosed / L.P.C. will be sent after Retirement

L.P.C. Enclosed

lled up by the Pension Sanctioning Authority

SRI. RANGA DEVANDAM,
Superintendent
Sri. Ranga Sadanandam
-----08-11-1953
13-03-1990
25-11-2011
Superintendent,
O/o the District Ednl Officer,
Nampally Mandal,
Hyderabad District.

Rule 33 Superannuation Pension (Rule 42)

Rule 34 Retiring Pension (Rule 43/44)
Rule 35 Pension on absorption under a Corporation
Rule 37 Invalid Pension
Rule 38 Compensation Pension
Rule 39 Compulsory Retirement Pension
Rule 40 Compassionate Retirement Pension
Rule 43 Retirement on completion of 20 years of qualifying service
Rule 44 Retirement on completion of 33 years of qualifying service
Rule 46 Retirement Gratuity
Rule 50 Family Pension

YES / NO

YES / NO
-----21 Years - 8 Months - 14 Days

NIL
NIL
NIL
NIL
NIL
NIL

21 Years - 8 Months - 14 Days

5 Years

26 Years - 8 Months - 14 Days

Rs. 4377 /-

B.P: Rs. 10900/- X D.A. @ 24.824% = Rs. 2706/(Rs.10900+Rs.2706) X 53 X 1/4 = Rs. 180280/As applicable to the case under consideration
N.A.
N.A.
As applicable to the case under consideration
#VALUE!
N.A.
N.A.
Total

Pension Issuing Authority. Amounts for recovery should be specified

on will be understood as no dues for recovery.

L.P.C. Enclosed

PART - II (B)
SANCTION OF PENSION

a) Certificate of competency to accord sanction (applicable in case of sanction of pension to Non-Gazett

including Class-IV Employees):
i)

I am declared by the Head of the Department to be the Head of the Office to accord sanction in
under the powers delegated vide G.O.Ms. No. 262, Finance & Planning (FW-PSC) Department,
1998.

ii)

I am the next Gazetted Authority in the heirarchy to the Head of Office in this case who is a Non
Officer and hence, I am competent to accord sanction under the powers delegated vide G.O. Ms
Finance & Planning (FW-PSC) Department , dated: 23-11-1998.

(Strike off whichever is not applicable)

b) SANCTION ORDER:

Pensionary benefits including commutation found admissible under the rules may be authorized. It is v
records in my custody and certify that no disciplinary or judicial proceedings are pending / contemplat
retiring / retired Government Servant to whom I am the authority for sanction of pension.

i)

Service Pension

Rs. 4377 /-

ii)

Retiring Gratuity

(Rs.10900+Rs.2706) X 53 X 1/4 = Rs. 180280/-

iii)

Commutation

#VALUE!

iv) Family Pension

a) Enhanced Family Pension

Rs. 00-00 /-

b) Normal Family Pension

Rs. 00-00 /-

Signature and Designation of

Pension Sanctioning Authority

Office Seal:
Date:
Note 1:

This is to be prepared in duplicate by the Pension Sanctioning Authority, one for the record
Sanctioning Authority and the other one to be sent to the Accountant General / Local F
Officer.

Note 2:

The Pension Sanctioning Authority should satisfy about the correcness of the particulars
furnished by the Government Servant/Applicant in Part-I.

Note 3:

If the pensionary benefits are not to be released, Part - II (B) shall be struck off.

Note 4:

If there is any likelihood of delay, Anticipatory Pension / Anticipatory Gratuity as per Rule
Revised Pension Rules, 1980 shall be drawn and paid by the Head of Office to the beneficia
any delay.

Note 5:

Heads of Departments are those listed in Appendix-I mentioned in Article 6 of A.P. Fina
Volume-I / Subsidary Rule 32 (ii) of F.R. 9.

PART - II (B)
CTION OF PENSION

(applicable in case of sanction of pension to Non-Gazetted Officers

ment to be the Head of the Office to accord sanction in this case

. No. 262, Finance & Planning (FW-PSC) Department, dt: 23-11-

heirarchy to the Head of Office in this case who is a Non-Gazatted

cord sanction under the powers delegated vide G.O. Ms. No. 262,
, dated: 23-11-1998.

ff whichever is not applicable)

nd admissible under the rules may be authorized. It is verified the

iplinary or judicial proceedings are pending / contemplated against
I am the authority for sanction of pension.

Rs. 4377 /-

(Rs.10900+Rs.2706) X 53 X 1/4 = Rs. 180280/-

#VALUE!

Rs. 00-00 /-

Rs. 00-00 /-

Signature and Designation of

Pension Sanctioning Authority

by the Pension Sanctioning Authority, one for the record of Pension

her one to be sent to the Accountant General / Local Fund Audit

y should satisfy about the correcness of the particulars of family

ant/Applicant in Part-I.

to be released, Part - II (B) shall be struck off.

Anticipatory Pension / Anticipatory Gratuity as per Rule 51 of A.P.
be drawn and paid by the Head of Office to the beneficiary without

listed in Appendix-I mentioned in Article 6 of A.P. Financial Code

of F.R. 9.

ANNEXURE - I
DESCRIPTIVE ROLLS
A. SPACE FOR PHOTOGRAPHS :

Single Photo

Service Pensioner / Family Pensioner /

Gratuitant / Guardian of Minor or Handicapped
Child

Joint Photo

Joint Photo of Service Pensioner with Family Pension b

Guardian with Minor or Handicapped Child.

(Attestation has to be done across the photoes by a Gazetted Officer of A.P. Government Service)

B. SPECIMEN SIGNATURE OF:

i)

Service Pensioner:

Specimen Signature of SRI. RANGA DEVANDAM

Son / Wife / Daughter of SRI. RANGA SADANANDAM
1)
2)
3)
ii) Family Pensioner / Gratuitant / Guardian of Minor or Handicapped Child:
Specimen Signature of SMT. R. LINGAVATHY
Wife of SRI. RANGA DEVANDAM
1)
2)
3)
C. PENSIONAL IDENTIFICATION MARKS OF :
i)

Service Pensioner : SRI. RANGA DEVANDAM

1. A mole on the left side of the stomache.
2. A mole on the right hand.

ii) Family Pensioner / Gratuitant / Guardian of Minor Handicapped Child:

1.

2.

D. LEFT HAND THUMB AND FINGER IMPRESSION OF SERVICE PENSIONER / FAMILY PENSIONER / GR
GUARDIAN OF MINOR OR HANDICAPPED CHILD :
(to be given by illeterate or those unable to sign and for others it is optional)

Details

Thumb Finger

Fore Finger

Middle Finger

Ring Finger

Service Pensioner

Family Pensioner

Gratuitant

Guardian of Minor/
Handicapped Child

Place:

07-11-2012

Date:

Hyderabad

Office Seal:

Attested By
Signature:

Name:
Designation:

(Attestestation has to be done by a Gazetted Officer of

A.P. State Government in Service)

Note:

(3) Copies will be forwarded to Accountant General / Local Fund Audit Officer by Pension
Authority and one will be retained by the Pension Sanctioning Authority.

ANNEXURE - I

DESCRIPTIVE ROLLS

Joint Photo

Joint Photo of Service Pensioner with Family Pension beneficiary /

Guardian with Minor or Handicapped Child.

the photoes by a Gazetted Officer of A.P. Government Service)

of Minor or Handicapped Child:

AM

e.

of Minor Handicapped Child:

SION OF SERVICE PENSIONER / FAMILY PENSIONER / GRATUITANT /

CHILD :

to sign and for others it is optional)

Little Finger

Attested By
Signature:

as to be done by a Gazetted Officer of

tate Government in Service)

ccountant General / Local Fund Audit Officer by Pension Sanctioning

by the Pension Sanctioning Authority.

ANNEXURE - II
NOMINATION

(The Government Servant may use separate forms, if he wishes to make different nominations for each type of payment, men

I here by nominate the person / persons mentioned below and confer on him /her /them the right to receive Life Time
Retirement Gratuity that may be sanctioned by Government, in the event of my death while in service and right to recieve on m
Arrears of Pension, Retirement Gratuity, Commuted Value of Pension, Death Relief which having become admissible to me on re
remain unpaid of my death.
1.

Name and address of Nominee(s)

SMT. R. LINGAVATHY

2.

Relationship with the Government Servant

WIFE

3.

Age

55 Years

4.

Amount of share payable to each in Column-1

Full Amount

5.

Contigencies on the happening of which the nomination shall become invalid (Death
need not be mentioned)

6.

Name and address, relationship and age of alternative nominee(s) to whom the right
conferred on the nominee(s) in Column-I shall pass in the event of the nomination to
him/ her/ them becoming ineffective

----

Amount of share payable to each in Column-6

NOT APPLICABLE

7.

This nomination supercedes the nomination made by me earlier on _________________ .

The Government Servant shall draw lines across the blank space below the last entry to prevent the insertions of any
has signed.

Note:

Dated this on 07-11-2012 day of 07-11-2012, 07-11-2012 at Hyderabad

WITNESS:
1.

Signature,
Address:

Name

and

2.

Signature,
Address:

Name

and

Sigature of the Government Serva

Name:

SRI. RANGA DEVANDAM

Designation:

Superintendent
O/o the District Ednl Officer
Nampally Mandal, Hyderabad District
COUNTER SIGNED

Signature of the Head of Office/ Department

Date:
Name & Designation:
Office Seal:
Note 1:

The Government Servant who has a family may nominate one member or more than one member or the family as defined in Rule 46(5) o
Rules, 1980

Note 2:

The Government Servant who has no family may nominate a person or persons, or a body of individuals, whether incorporated or not.

Note 3:

The Government Servant may note that the nomination with signature of two witness shall only have the legal validity of WILL.

Note 4:

This nomination form is to be submitted by the employees in triplicate, one for use of the Pension Sanctioning Authority and two copies t
Accountant General/ Local Audit Officers.

Note 5:

For the purpose of Rules 46, 47 and 49 of A.P. Revised Pension Rules, 1980, Family in relation to a Government Servant means:

i)
ii)
iii)

Wife or wives in the case of Male Government Servant

Husband in the case of a Female Government Servant.
Sons including step sons, posthumous son and adopted daughters ( whose personal law permits such adoption)

iv)

Unmarried daughters including step daughters posthumous daughters and adopted daughters (whose personal law permits such adoption.

v)
vi)
vii)
viii)

Widowed daughters including daughters and adopted daughters.

Father including adoptive parents in the case of individuals whose personal law permits adoption.
Mother including adoptive parents in the case of individuals whose personal law permits adoption.
Brothers below the age of 18 years including step brothers.

ix)
x)
xi)

Unmarried sisters and widowed sisters including step sisters.

Married daughters and
Children of a predeceased son.

ANNEXURE - II
NOMINATION

he wishes to make different nominations for each type of payment, mentioned below)

d below and confer on him /her /them the right to receive Life Time Arrears of Pension,
t, in the event of my death while in service and right to recieve on my death, Life Time
f Pension, Death Relief which having become admissible to me on retirement which may

SMT. R. LINGAVATHY
WIFE
55 Years
Full Amount

---NOT APPLICABLE

er on _________________ .

s the blank space below the last entry to prevent the insertions of any name after he/she
Hyderabad

Sigature of the Government Servant

SRI. RANGA DEVANDAM
Superintendent
O/o the District Ednl Officer
Nampally Mandal, Hyderabad District
COUNTER SIGNED

one member or more than one member or the family as defined in Rule 46(5) of A.P. Revised Pension

a person or persons, or a body of individuals, whether incorporated or not.

h signature of two witness shall only have the legal validity of WILL.

s in triplicate, one for use of the Pension Sanctioning Authority and two copies to be forwarded to the

sion Rules, 1980, Family in relation to a Government Servant means:

ughters ( whose personal law permits such adoption)

daughters and adopted daughters (whose personal law permits such adoption.

hters.

whose personal law permits adoption.

whose personal law permits adoption.

s.

ANNEXURE - III
BY REGISTERED POST
From:
Gaz. Head Master Gr-II,
Govt. High School, Malakpet,
Saidabad Mandal,
Hyderabad District.
(Pension Sanctioning Authority)
To:
The Accountant General (A & E),
Andhra Pradesh, Hyderabad-500004.
(Disciplinary Authority/ Appointing Authority/ Head of the Department

Sub:

Pension - Sanction of Pension and other retiring benefits in respect of SRI. RANGA DEVAN
Superintendent working at O/o the District Ednl Officer, Nampally Mandal, Hyderabad Distri
-o0o-

I am to inform you that, the Pensioner / Family Pensioner application from SRI. RANGA D

on 25-11-2011 as Superintendent was forwarded to AGAP / LFA on _____________ as per the record

disciplinary / judicial proceedings are against the above retiring / retired Government Employee. I req

whether any such case is pending / contemplated against the above retiring / retired Government Em

you to verify whether any such case is pending against the above employee which entails withholdin

pension or part of pension permanently or for specified period as laid down under Rule 9 of Revise
1980. If so the AG (A & E) / Deputy Accountant General (Pension), O/o the Accountant General
Pradesh, Hyderabad / Local Fund Officer may be intimated accordingly by name either by registered

special messenger within one month from the date of issue of this letter for withholding pensio

contemplated in Govt. Memo. No. 33764-A/55/PSC/93, Finance & Planning (FW-PSC) Department, dt

reiterated in Govt. Memo No. 37254/361/A2/Pen-I/98, Finance & Planning (FW-Pen.I) Department

Copies of such orders shall also be sent to the concerned Treasury Officer / P.P.O. for withholdin

benefits. In this connection the instructions issued in Para 2, Part-II B of G.O. Ms. No. 263, Finance
PSC) Department, dt:23-11-1998 may be scrupulously followed.
Yours Sincerely,
Station:

Hyderabad

Date:

Pension Sanctioning Au
Gaz. Head Master Gr
Govt. High School, Mal
Saidabad Mandal,

NEXURE - III
GISTERED POST

ring benefits in respect of SRI. RANGA DEVANDAM, Designation

dnl Officer, Nampally Mandal, Hyderabad District - Reg.
-o0o-

amily Pensioner application from SRI. RANGA DEVANDAM retires

AP / LFA on _____________ as per the records held by me, no

retiring / retired Government Employee. I request you to verify

st the above retiring / retired Government Employee. I request

t the above employee which entails withholding or with-drawing

ed period as laid down under Rule 9 of Revised Pension Rules,

neral (Pension), O/o the Accountant General (A & E), Andhra

ted accordingly by name either by registered post or through a

of issue of this letter for withholding pensionary benefits as

Finance & Planning (FW-PSC) Department, dt:15-10-1993 and

8, Finance & Planning (FW-Pen.I) Department, dt:04-07-1998.

erned Treasury Officer / P.P.O. for withholding the pensionary

Para 2, Part-II B of G.O. Ms. No. 263, Finance & Planning (FW-

followed.
Yours Sincerely,

Pension Sanctioning Authority

Gaz. Head Master Gr-II,
Govt. High School, Malakpet,
Saidabad Mandal,

Appendix - 2 (Refered to Paper 21-1)

See Article 62, Hyderabad Civil Service Regulations, NEW APTC 161
Any Pay Manual of Pension 1975, see Page No. 67
LAST PAY CERTIFICATE

1. Last Pay Certificate of SRI. RANGA DEVANDAM, Superintendent of the O/o the District Ednl Officer, Nam
Hyderabad District.
2. He/she has been paid up to 25-11-2011 at the following rate:
Scale of Pay:

Rs. 14860-39540 / 10900

Pay Particulars

Basic Pay

Deductions
10900 =00

Spl. Pay / P.P.

125 =00

A.P.G.L.I.S.
G.I.S.

D.A. @ 24.824

2706 =00

Prof. Tax

H.R.A.

2180 =00

Other if any

C.C.A.

130 =00

S.C.A.

550 =00

Other if any

500 =00

TOTAL

17091 =00

TOTAL

3. He/she made over charge of Superintendent, O/o the District Ednl Officer in the after noon of 25-11-20
4. Recoveries are to be made from the pay of the Government Servant as detailed in the recoveries.
5. He/she has been paid leave salary as detailed above deductions has been made as:
PERIOD

RATE

AMOUNT

From ___________ to ____________ _____________ to

Rs. ______________ a month

From ___________ to ____________ _____________ to

Rs. ______________ a month

From ___________ to ____________ _____________ to

Rs. ______________ a month

From ___________ to ____________ _____________ to

Rs. ______________ a month

6. He/she is entitled to draw the following:

7. He/she is also entitled to joing time for _______________________.

8. The details at the Income-Tax recovered from him/her upto the date from beginning to the current ye
the recovers.

Date:
Place:
Signature of the
Certifying Officer.

2 (Refered to Paper 21-1)

Civil Service Regulations, NEW APTC 161
of Pension 1975, see Page No. 67

T PAY CERTIFICATE

uperintendent of the O/o the District Ednl Officer, Nampally Mandal,

llowing rate:

Deductions
450 =00
30 =00
150 =00
200 =00

830 =00
the District Ednl Officer in the after noon of 25-11-2011.

overnment Servant as detailed in the recoveries.

ove deductions has been made as:

AMOUNT

_____________ to

Rs. ______________ a month.

_____________ to

Rs. ______________ a month.

_____________ to

Rs. ______________ a month.

_____________ to

Rs. ______________ a month.

________________.

m/her upto the date from beginning to the current year are noted on

Signature of the
Certifying Officer.

APPENDIX
DETAILS OF RECOVERIES
Nature of Recoveries
Amount of Rupees
To be recovered in

Installments
DEDUCTION MADE FROM THE LEAVE SALARY

From . To .. On Account of . Rs.

From . To .. On Account of . Rs.
From . To .. On Account of . Rs.
From . To .. On Account of . Rs.

Name of the
Month
April
May
June
July
August
September
October
November
December
January
February
March

Pay

Gratuity Fee etc.,

Funds & Other

Deductions

Amount of Income
Tax recovered

APPENDIX
TAILS OF RECOVERIES

Installments
MADE FROM THE LEAVE SALARY

of . Rs.

of . Rs.

of . Rs.

of . Rs.

Remarks

NO DUES CERTIFICATE

This is to certify that, there are no any kind of dues to be recovered from SRI. RANGA D
Superintendent, Nampally Mandal, Hyderabad District.
1. Sales Proceedings of A.P. Trading Corporation.
2. Nationalised Text Books and Note Books as they are not supplied / supplied to him.

NO ALLEGATIONS OF PENDING CHARGES CERTIFICATE

This is to certify that there are no any kind of allegations or pending charges against S
DEVANDAM, Superintendent, O/o the District Ednl Officer, Nampally Mandal, Hyderabad District.

NO AUDIT OBJECTIONS CERTIFICATE

This is to certify that, there are no any kind of Audit Objections / Paras Pending against S
DEVANDAM, Superintendent, O/o the District Ednl Officer, Nampally Mandal, Hyderabad District.

NON-SUSPENSION CERTIFICATE

This is to certify that SRI. RANGA DEVANDAM, Superintendent, O/o the District Ednl Office
Mandal, Hyderabad District.

RESPONSIBILITY CERTIFICATE

I, SRI. RANGA DEVANDAM S/o / D/o / W/o Sri. Ranga Sadanandam to be retired as Superinte
the school/office of O/o the District Ednl Officer, Nampally Mandal, Hyderabad District do hereby dec
any amount found to be excess paid due to erroneous caleculation noticed at a later date, I shall b
refund the same without any objection in the matter.
Station:
Date:

Pensioner

(SRI. RANGA DEVANDAM)

Superintendent, O/o the Dist
Officer, Nampally Mandal.

Drawing Officer

NO DUES CERTIFICATE

any kind of dues to be recovered from SRI. RANGA DEVANDAM,

d District.

on.

s they are not supplied / supplied to him.

S OF PENDING CHARGES CERTIFICATE

o any kind of allegations or pending charges against SRI. RANGA

Ednl Officer, Nampally Mandal, Hyderabad District.

IT OBJECTIONS CERTIFICATE

any kind of Audit Objections / Paras Pending against SRI. RANGA

Ednl Officer, Nampally Mandal, Hyderabad District.

SUSPENSION CERTIFICATE

DEVANDAM, Superintendent, O/o the District Ednl Officer, Nampally

ONSIBILITY CERTIFICATE

/ W/o Sri. Ranga Sadanandam to be retired as Superintendent from

cer, Nampally Mandal, Hyderabad District do hereby declare that, if
erroneous caleculation noticed at a later date, I shall be ready to
matter.

Pensioner
(SRI. RANGA DEVANDAM)
Superintendent, O/o the District Ednl
Officer, Nampally Mandal.

From

To

Gaz. Head Master Gr-II,

Govt. High School, Malakpet,
Saidabad Mandal,
Hyderabad District.

The Accountant General (A & E),

Andhra Pradesh,
Hyderabad - 500004.
Lr. No. ____________________, dt: _________ .

Sir/Madam,

Sub: Forwarding of Pension Papers in respect of SRI. RANGA DEVANDAM, Superintenden

District Ednl Officer, Nampally Mandal, Hyderabad District - Reg.
-o0o-

I am here with forwarding the advance Pension Papers in quadruplicate of SRI. RANGA D
Superintendent, O/o the District Ednl Officer, Nampally Mandal, Hyderabad District who is to retire on 25-11

The following documents are sent herewith for authorising pensionery benefits of the pensioner.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

Part - I : Information of the Applicant.

List of Family Members of the Applicant.
Declaration.
Proforma to be filled in by the Head of the Office.
Part - II (A).
Part - II (B).
Annexure - I : Descriptive Rolls and ABCD.
Annexure - I : Nomination.
Annexure - III.
Last Pay Certificate.
Certificates:
i)
No Dues Certificate.
ii)
No Allegations of Pending Charges Certificate.
iii)
No Audit Objections Certificate.
iv)
Non Suspension Certificate.
v)
Responsibility Certificate.
12. Service Register of the Pensioner.
13.

The receipt of the advance pension papers along with Service Register may please be acknowl
necessary arrangements may please be made for issue of Pension Payment Order, Gratuity Payment
Commutation Authorization.
Yours faithfully,
To
Sri. Ranga Devandam, Superintendent, O/o
the District Ednl Officer.

Gaz. Head Master Gr-II

Govt. High School, Malakpe
Saidabad Mandal
Hyderabad District

General (A & E),

004.

ANDAM, Superintendent, O/o the

ate of SRI. RANGA DEVANDAM,

ho is to retire on 25-11-2011.

of the pensioner.

may please be acknowledged and

der, Gratuity Payment Order and
Yours faithfully,

az. Head Master Gr-II

t. High School, Malakpet
Saidabad Mandal
Hyderabad District

PROCEEDINGS OF THE GAZ. HEAD MASTER GR-II :: GOVT. HIGH SCHOOL, MALAKPET :: SAIDABA
HYDERABAD DISTRICT
Present : Sri. B. Venkateswarlu, B.Sc., B.Ed.
Rc.No. ___________________

Date: ____

Sub: Pension - Santion of Pensionery Benefits to Sri. Ranga Devandam, Superintendent, O/o t
Officer, Nampally Mandal, Hyderabad District who will retire from his/her service in the A.N.
- Orders Issued.
Ref:

1)

G.O. Ms. No. 262 F & P Dept., dt: 23-11-1998.

2)

G.O. Ms. No. 40 Education Dept., dt: 07-05-2002.

3)

G.O. Ms. No. 87 F & P Dept., dt: 25-05-1998.

4)

G.O. Ms. No. 249 F & P Dept., dt: 04-10-2005.

5)

G.O. Ms. No. 158 F & P Dept., dt: 16-09-1999.

6)

Other related papers submitted by the incumbent.

-o0o-

In terms of the G.O's cited Pensionary Benefits are here by sanctioned to SRI. RANGA DEVANDAM,
O/o the District Ednl Officer, Nampally Mandal, Hyderabad District who will retire from his service on Super
A.N. of 25-11-2011. The Pensionary Benefits are payable at S.B.I., Malakpet Branch with A/c No. 10235678
Qualifying Service

21 Years - 8 Months - 14 Days with a weightage

been taken in to account.

Superannuation Pension

#VALUE!

Retirement Gratuity

Rs. 180280 /-

Commutation

#VALUE!

In case of Death of the Pensioner, the Family Pension Payable to Smt. R. Lingavathy Wife of Sri. Ra
Superintendent who is going to retire from O/o the District Ednl Officer Rs. 4377 /- period of upto 7 Year
Rs. 5243 /- till his/her remarriage of Wife or death which ever is earlier.

The Pensioner is informed that, if the amount now sanctioned is later found to be excess of what he/s
will be held responsible and called upon to refund such excess amount.

To
The individual concerned.
Copy forwarded to the A.G.A.P., Hyderabad along with the following documents on behalf
of Sri. Ranga Devandam and to release Pensionary Benefits at an early date.
1. Service Register.
2. Pension Proposals (3) sets.

Copy to the file.

I :: GOVT. HIGH SCHOOL, MALAKPET :: SAIDABAD MANDAL ::

ERABAD DISTRICT

B. Venkateswarlu, B.Sc., B.Ed.

Date: ______________

fits to Sri. Ranga Devandam, Superintendent, O/o the District Ednl

District who will retire from his/her service in the A.N. of 25-11-2011

: 23-11-1998.
dt: 07-05-2002.

25-05-1998.
04-10-2005.
16-09-1999.

y the incumbent.
-o0o-

are here by sanctioned to SRI. RANGA DEVANDAM, Superintendent,

bad District who will retire from his service on Superannuation in the
ble at S.B.I., Malakpet Branch with A/c No. 102356789145.
21 Years - 8 Months - 14 Days with a weightage of 5 Years has
been taken in to account.
#VALUE!
Rs. 180280 /#VALUE!

ension Payable to Smt. R. Lingavathy Wife of Sri. Ranga Devandam,

istrict Ednl Officer Rs. 4377 /- period of upto 7 Years, there after @
ch ever is earlier.

w sanctioned is later found to be excess of what he/she is entitled to

excess amount.

with the following documents on behalf

Benefits at an early date.

DDO

Identification Marks of Pensioner as per Govt. Finance (PSC) Dept.,

Circular Memo No. 13910/90/A1/PSC/04, dt:21-06-2004 with reference to A.G's Lr.No. P
7/2004/05/U.IV/10, dt: 04-06-2004
N.B: To be sent to A.G. in Triplicate

Certified that, the following are the identification marks of Sri. Ranga Devandam who is retired
Superintendent from the office of the O/o the District Ednl Officer, Nampally Mandal, Hyderabad Distric
1. A mole on the left side of the stomache.
2. A mole on the right hand.

(Certifying Author

PHOTOS as per Govt. Finance (PS) Dept., Circular Memo No. 13910/90/A1/PSC/04, dt: 21
issued with reference to A.G's
Lr.No. PM/1/7-7/2004/05/U.IV/10, dt: 04-06-2004
1. Photos of Pensioner

: Sri. Ranga Devandam

2. Designation

: Superintendent

3. Office

: O/o the District Ednl Officer, Nampally Mandal, Hyd

District.

4. Retires on

: 25-11-2011

Four photos to be enclosed with written name of

pensioner on back and attested on photos by
Competent Authority.

Pensioner as per Govt. Finance (PSC) Dept.,

/04, dt:21-06-2004 with reference to A.G's Lr.No. PM/1/7/05/U.IV/10, dt: 04-06-2004

o be sent to A.G. in Triplicate

ntification marks of Sri. Ranga Devandam who is retired/ retiring as

District Ednl Officer, Nampally Mandal, Hyderabad District.

(Certifying Authority)

., Circular Memo No. 13910/90/A1/PSC/04, dt: 21-06-2004

d with reference to A.G's
7/2004/05/U.IV/10, dt: 04-06-2004
Sri. Ranga Devandam
Superintendent
O/o the District Ednl Officer, Nampally Mandal, Hyderabad
District.
25-11-2011