Professional Documents
Culture Documents
Farewell Grant Proforma
Farewell Grant Proforma
PART-I
1
Basic pay
Special pay
Technical pay
Personal pay
Qualification pay
Any other pay
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
Date of Birth
__________________________________________
__________________________________________
a) PARC
__________________________________________
b) Other organization
__________________________________________
Length of Service
From
To
Y
Period
M
PARC
Other organization
Total service
5
6
Date of retirement
__________________________________________
Period for which contributions to Benevolent and Group Insurance Funds were not
paid _________________________________________________________________
7
8
SIGNATURE OF THE
EMPLOYEE
PART-II
1. Certified that the information contained in Part-I of the application form is correct
according to our record.
2. Certified that the above named employee was neither a contingent paid/work charged
employee nor a deputationist from a provincial Government/Autonomous body.
3. Certified that the farewell grant claim has been preferred for the first time.
4. following documents are submitted with claim:
(Annex-I)
(Annex-II)
(Annex-III)
(Annex-IV)
(Annex-V)