A.P.F.

C FORM-49
(See subsidiary Rule 13 under Treasury Rule.16)
PERIODICAL INCREMENT CERTIFICATE
Certify that every Government servants name below has/have earned the prescribed increment for the dates noted in column (10 and (b) and has been the incumbent of
the appointment indicated against his name, their names for a period of not less than one year since the date in column (5) or that he/has they have been suspended for
misconduct column (7) after deducting the period between the dates shown in column(8) and (9) land has not been subjected to the order of stopping of increment as a
penalty during the period and the during periods of leaves average pay taken at a time of ______________to_________ and that to which has/have been counted for
increment in the case of officiating government servant /servants name below he/ they would have officiated on the post/posts but for his they’re going on leave of:

S.n Name Appointm Wheth Date Suspensi Leave without Pay and Date from Scale of pay Rs. Present Amount Future
o ent er from on for the case those holding which pay of pay
substa with miscondu the post temporarily or increment increme
ntive present ct in an officiating may be nt Rs.
or pay is capacity all kinds of given
officiati drawn leave other than leave
ng on average pay during
which they would have
continued the
officiating in the posts
but for their going on
leave up to a max. of 4
months of such leave
taken at a time
31460-880-33220-950-36070-1030-39160-
1 SK RAMIZA PGT- ENGLISH officiating 01.10.2018 - - - 01.10.2019 1110-42490-1190-46060-1270-49870- 35120 950 36070
1360-53950-1460-58330-1560-63010-
1660-67990-1760-73270-1880-78910-
2020-84970
31460-880-33220-950-36070-1030-39160-
2 S VASANTHI PGT-MATHS officiating 01.10.2018 - - - 01.10.2019 1110-42490-1190-46060-1270-49870- 35120 950 36070
1360-53950-1460-58330-1560-63010-
1660-67990-1760-73270-1880-78910-
2020-84970

Note: 1. When in increment claimed to carry and govt. servant over and efficiency for the claim should be supported by a declaration from the competent authority that it
has satisfied itself that the character and efficiency of the government servant concerned are such that he is fit to pass the bad and column (5) and (1) and should to filled
up in red ink.
2. the term leave on average pay up to maximum of 4 months whenever accruing in the form included earned leave up to a maximum of 20 days or 50 days or 30 days as
the case may be for a government servants governed by the A.P.I 1958 are concerned.
3. The service of the individual satisfactory and no disciplinary cases are pending against during the period of the increment.
 CERTIFICATE
(As laid down in Government Memo No. 104215-a/1620/Pen.II/76-I, Dated. 1.1.1977)

Certify that __________________________________________________whose basic pay is __________________has already insured under policy no. nil of the director of
insurance, AP., Hyderabad or its Regional Offices and monthly premium Rs. Nil is being conducted from his salary in accordance with the rule of compulsory insurance
scheme applicable to AP state employee and a sum of Rs. Nil towards monthly premium is paid in to challn no. Nil dated Nil towards compulsory insurance scheme
applicable to Government servant as per G.O Ms. No 337 F & P dated 3.8.1976.

Certify that age of years exceeded __years and hence he cannot insure the life with Govt Life Insurance Department