COAL INDIA LIMITED

(A Maharatna Company) (\ry'rrdr{dEiilTfr(

Coal Bhawan,
mtdril{
Premise No-04 MAR, Plot No-AF-lll,
qf{tR€.- o+ MAR, wft-dri.- Rr-lrr,
Action Area-1A,
Newtowh, Rajarhat,
qffi'f{qRqT-1A,
Kolkafa-7 00156 q{crs{, llcl-{6[d,
Website: www.coalind ia. in o_tf,f,rdr-7oo1s6
?q' www.coalindia.in

Ref No: CIL/C-5C/5512512O211LoB t Date: 05.07.2021 :

To
All Nodal Officers of CPRMSE,
ECL, BCCL, CCL, SECL, NCL, MCL, WCL, CMPDIL

SUB: Revised format of Phvsica!/ Hard Gopv of the Life Gertificate (CPRMSE)

Dear All,

This is in reference to the amendments in Contributory Post Retirement Medicare Scheme for
Executives of CIL & its Subsidiaries vide office order no: CIL/C5A(PC)/CPRMSE/614
dated:31 .03.2021.

ln continuation to the aforementioned office order, it is informed that henceforth all the retired
Executives and/ or Spouse will have the option to submit either a "physical copy of Life
Certificate" in the attached format or a "Jeevan Pramaan Certificate/ Digital Life
Certificate" through any citizen service centre, everv vear in the month of November. starting
from November 2021.

The new format of physical copy of the Life Certificate (office order
Cl L/CSA( PC)/CPRMS El 694 dated : 02. 07 .2021) is hereby attached.

Thanking You
Yours faithfully,

Xf *a?t$
Dy.G. M(PA//elfare)

Distribution- Person Concerned

Copy To- Director (P)- WCL/ SECLI ECL/CCL/ MCLI NCL/ BCCL
Director (T&CRD)- CMPDI
ED/TS to Chairman- CIL
ED (CD & Welfare) CIL
ED (Medical) CfL
GM(P/EE) CrL
GM(System) CIL
GM(Finance) CIL
TS to D(P&TR), CIL
atmqFilftfrk PERSONNEL DIWSION
(l{r{dg{fiT{6'rgrflT) POLICY CBLL
COAL INDIA LIMITED CIN: L23 I 09WB I 973G01028844
(A Govt. of India Enterprise) E-Mail : policycell.cil@coalindia.in
atg q-+c "coAL BHAwAN" Tel: 033-71 10 4211
Premise No. 04, MAR, Plot No. AF-lll
Actron Area-1A, Newtown, Rajarhat
q6'T6rraiitqft Website: www.coalindia.in
KOLKATA-7OO t 56 (WB) A Maharatna Company
(An ISO 9001:2015, ISO 14001:2015 & ISO 50001:2011 Certified Company)

+iEat qi: CtLl Cs A (PCyCPRMSE/694 fufu:02.07.2021

frYq: Revision in Life Certificate Format(CPRMSE)

The competent authority of CIL has approved revision in Life Certificate format under
Contributory Post Retirement Medicare Scheme for Executives of CIL & its Subsidiaries
(CPRMSE) for implementation with immediate effect.

The revised format is enclosed herewith for information and compliance by all concerned.

*wA6
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rdredrrn (fi,r./ frtr)
S-trdtEr?,qntfuil{oT:
r. D(ryD(MyD (P&rRyD (FyCrL
2. CMD, BCCL/ CCLI CMPDILI ECLI MCL/ NCL/ SECL/ WCL
3. CVO, CIL
4. D(P), BCCL/ CCLIECLI MCL/ NCL/ SECL/ WCL
5. D(T/CRD), CMPDIL
6. CVO, BCCL/ CCL/ CMPDILI E,CL/ MCL/ NCL/ SECL/ WCL
7. ED(Coordination)/ED(Community Development), CIL
8. GM(P/EEyGM(Fin),CIL
9. GM,NEC
10. HoD, CIL New Delhi Office
11. HoD, IICM
12. Manager (P/PC), CIL - for uploading the OM in CIL website
 LIFE CERTIFICATE
TO BE SUBMITTED BY CPRMSE BENEFICIARY IN NOVEMBER EVERY YEAR

A. This is to certify that Shri , ond

Smt. holder of the Post-Retirement Medical
Card Number (Couple Membership): residing at

are known to me and alive at the time of issuing this certificate.

OR

B. This is to certify that Shri / Srnt. husband / wife of

Shri / Smt. holder of the
Post-Retirement Medical Card Number (Single Membership):
residing at
are known to me and alive at the time of issuing this certificate.

*Strike off whichever is not applicable

The signature/s of the above mentioned person(s) is /are attested hereunder:

(Note: In case of couple membership signature of both beneficiaries i.e. ex-employee and spouse is mandotory)

Signature of Retired executive Signature of spouse

Narne (Shri/ Smt) Name (Shri/ Smt)
Contact No Contact No
Aadhaar Card No Aadhaar Card No
Date Date _l_l_
DD/ MM /YYYY DD/ MM / YYYY

Signature of Registered Medical Practitioner with Reg. No OR

Gazetted Officer of Central/ State Govt. OR
The Branch Manager of the Bank where the retired executive/ spouse is holding S.B A/c OR
Any officer of the company from where the medical facility is obtained
with seal/ stamp

DBCLARATION
*IA[e hereby declare that I/we meet all the eligibility criteria as per the CPRMS-E Policy clause no:02 and
declare that if any facts to the contrary are detected, the Company (CIL or Subsidiary Company) shall be
free to cancel said benefits without any further reference to me/us.
Place:
Date: Signature of the Beneficiary