Form 3 (PEN)

PENSION PAPER
Name _ MUHAMMAD SHOUKAT _____

Father/ Husband Name: ABDUL JALEEL _____________

CNIC No: 13503-0208679-9__ __________

Designation: HEAD MASTER, GHS BAKKI MANSEHRA

Department: EDUCATION (E& S.E) KPK

Personal No: 00222937

Date of Retirement / Death: 30-04-2023 (A.N)

DDO Code MA-6108

Bank Branch N.B.P. SHINKIARI BRANCH (MANSEHRA)

Bank Account No PLS-4950-2

Contact No
 Form 3 (PEN)

APPLICATION / CERTIFICATE TO BE GIVEN BY THE PENSIONER FOR PENSION / GRATUITY /COMMUTATION

[To be given by retiring government servant for grant of pension in case of superannuation / retiring /

Invalid / compensation / compulsory retirement]

The District Education Officer (M) Mansehra

Sir / Madam
It is submitted that I MUHAMMAD SHOUKAT Father/Husband Name: _ABDUL
JALEEL Designation/Post held HEAD MASTER BPS 17 on Regular basis (Please
indicate kind of appointment i.e. Regular/Officiating or Acting charge / current charge) w.e.f 1-9-1985 _____
having CNIC No. (Copy enclosed) 13503-0208679-9 Nationality Pakistani Personal
No. 00222937
Cell No. (i) ______ (ii) ____________________Gmail: ______________
Postal Address_____________________________
That I have retired / have been permitted to retire from Government service / I am due to retire / has been
retired compulsory on 30-04-2023 (A.N). My pension / commutation / gratuity may be transferred / credits
by the Accounts Office in the Bank / Post Office / Treasure office NBP SHINKAIARI BRANCH ) having
account No. PLS-4950-2 {DCS form (where applicable) and list of my family members is enclosed}
Undertaking
1. I do hereby declare that I am not in receipt of any other pension, military or otherwise except PPO No ________
Dated ____________ Amount _______________ Department _______________ retired on ________________
2. I do hereby undertake that government may, within one year from the issue of my Pension Payment Order, recover
any of its dues from the pension granted to me.
3. I do hereby declare that I shall not take part in any election or engage myself in political activities of any kind within
two years from the date of retirement.
4. I do hereby declare that I have neither applied for nor received any pension / commutation / gratuity in respect of any
portion of the service included in this application and in respect of which pension / gratuity is claimed herein, nor shall
I submit any application hereafter without quoting a reference to this application and to the order which may be passed
thereon.
5. I do hereby undertake to refund if the amount of pension granted to me afterwards found to be in excess of that to
which I am entitled under the regulations.
6. I do hereby declare that I have not received any pension or gratuity in respect of any portion of the service included in
this application.
7. I hereby option for commutation @ 35% (subject to maximum of 35%) of my gross pension.
Dated: 17-7-2023

Signature of Retiring Government servant: _______________________

Name of Retiring Government servant: MUHAMMAD SHOUKAT

HEAD OF OFFICE/DEPARTMENT

Note: Pension to be verified by Pension Sanction Authority / DDO

 Form 3 (PEN)

APPLICATION FORM TO BE USED IN CASE OF SUPERANNUATION / RETIRING /INVALID /

COMPENSATION / COMPULSORY RETIREMENT]

[To be issued by the Sanctioning Authority 90 days before superannuation / retirement of the retiring
Government servant]

Subject: SANCTION OF PENSION ON SUPERANNUATION / RETIRING /INVALID /

COMPENSATION / COMPULSORY RETIREMENT

On attaining the age of superannuation / having applied for retiring / invalid / compensatory pension vide
application dated ________ OR has been retired vide Notification No NO.AO/E&SED/6-23-/LPR/MANSEHRA
Dated 20-6-2023 issued by DISTRICT EDUCATION OFFICER (M) MANSEHRA
Mr. / Mrs. / Ms MUHAMMAD SHOUKAT S/O, W/O, D/O ___________________________.
Designation HEAD MASTER drawing pay / emoluments Rs. 133970 (reckonable towards pension),
in BPS 17 on Regular basis (Please indicate nature of appointment i.e. Regular/Officiating or Acting
Charge/Current charge) w.e.f ________ Personal No. 00223937 CNIC No. 13503-0208679-9-
Presently posted as HEAD MASTER at GHS BAKKI (Mansehra)
has retired / has been permitted to retire is due to be retired has been retired
compulsory from the Government service (Tick whichever is applicable) on 30-04-2023 after availing
LPR for 365 days / Leave encashment in lieu of LPR Rs. 1607640/-
Pension Calculation:
Gross Pension Rs. 93779/-__
Commutation Rs. 5509793.84/-
Net Pension Rs. 60956/-__
Other Benefits:
i. GPF Rs. ________
ii. LPR Rs. 1607640.00
iii. EEF Rs. 50000.00_
Gratuity: (In case where qualifying service is 5 years or more but less than 10 years) Rs. ______
(1) His / Her date of birth is 1-09-1966 Date of 1st entry into Govt: service is 1-09-1985
And EOL availed is days. Total length of qualifying service for pension is
37 Years 07 Months 29 days
(2) Certified that no inquiry is pending against him / her.
(3) Certified that no recovery is outstanding against him / her.
(4) Certified that
i. Advances drawn (if any) stand fully repaid, along with interest.
ii. An amount of Rs. On account of (HBA/MCA/etc) principal
amount along with interest is outstanding which may be recovered from the pension.
(5) Anticipatory pension up to ( %) of full pension is sanctioned as admissible to him / her.
(6) Certified that deficiency / disciplinary / criminal cases pending against the aforementioned retired
government servant has been finalized. Therefore, final pension payment @ ( ) (After
adjustment of already paid amount of anticipatory pension) and commutation amounting ( ____ % )
(Subject to a maximum of 35% gross pension), as determined by concerned account office, may be paid.

(7) Undersigned is satisfied that the service of retiring employee has been satisfactory. Administrative and
financial sanction for the grant of pension / commutation @ 35% up to maximum of 35% of gross
pension, if so opted by the retiring government servant, to be determined by the Accounts office, is
hereby accorded in favour of Mr. / Mrs. / Ms. MUHAMMAD SHOUKAT through bank /
Post Office / Treasure office NBP SHINKIARI Branch (Mansehra) Branch Code (_____) having
account No. PLS-4950-2 (Mentioned in DCS form enclosed) as admissible under the rules.
OR

(7-a) Undersigned is satisfied that the services of Mr. / Mrs. / Ms. _________________ has not been
satisfactory and it has been decided that the full pension / gratuity found to be Audit / Account Officer to
be admissible under the rules should be reduced by the specific amount or percentage given below.
i. Amount or percentage of reduction in pension ___________________
ii. Amount or percentage of reduction in gratuity ___________________
iii. Sanction is hereby accorded to the grant of pension / gratuity as so reduced.

(8) The payment of pension and / or gratuity may be commence w.e.f 1-05-2023

Following documents attached:

1. Pension Application 8. Dependent list
2. Notification of retirement 9. Specimen signature / Left, Right hand thumb
3. Last Pay Certificate / Last payslip and fingers impression Form
4. Pension contribution receipts / Bank chalan / 10. No demand, Declaration, Undertaking &
acceptance certificate (in service death) Option Certificate
5. Original service book along with its attested copy 11. Pensioner Bank Account Details
/ service statement (in case of gazetted government servant)
6. NDC from estate office in case of Government accommodation
7. Three attested photograph of pensioner.

HEAD OF OFFICE/DEPARTMENT SIGNATURE WITH STAMP

PENSION SANCTION AUTHORITY
1. The AGPR / Accounts Office is required to grant pension and endorse a copy of computerized pension
payment order (C.P.P.O) / Pension Payment Order (P.P.O) to this department / office
2. Mr. / Mrs. / Ms. MUHAMMA SHOUKAT you are hereby informed that your commutation (if
opted) and first monthly pension shall be transferred / credited by Accounts Office in the Bank / Post
Office / Treasure office NBP SHINKARI Branch Mansehra Branch Code ( ) having account
No. PLS-4950-2 as opted by you.
 Personal No. 00222937
LAST PAY CERTIFICATE
1. Last Pay Certificate of MUHAMMAD SHOUKAT HEAD MASTER S/O ABDUL JALEEL
Office of the GHS BAKKI (Mansehra)
Proceeding to Retirement on 30-4-2023(AN)
2. He has been paid up to 30-4-2023
as per following .
0001 … Pay Rs: 133970/-
Particulars:- 1000 … HRA Rs 6650/-
1210.. Con All Rs 5000/-
` Submitting Pay:- 1300 .. Med All Rs 3373/-
1505- Chg All Rs 100/-
2148 Adh 2010 1178/-
2199 Adh 2015 1178/-
2316 TEAC: ALLOW 6074/-
2224 DISP:ALLOW 13180/-
Officiating Pay:- 2247 Adh 2022 13180/-
Exchange Compensation Allowances:-
TOTAL RS:- 184460/-
DEDUCTION:-
3015… GPF Rs 4270/-
6505 …GPF Adv 000
3501 … B/F Rs 1500/-
3640 … EEF Rs 270/-
4004 … Ret. Benif & Death 11977/-
3609…. Incom Tax 00/-
Total 20997/- NET PAY:- Rs 163469/-

3. He made over charge of the office of GHS BAKKI MANSEHRA on the afternoon of 30-04-2023
4. Recoveries are to be made from the pay of the Government servants as detailed on the reserve.
5. He has been paid Leave Salary as detailed below. Deductions have been made as noted on the reserve.
From _______________________ to _________________________ at Rs _____________ a month
From _______________________ to _________________________ at Rs _____________ a month
6. He is entitled to draw the following:-
7. He is also entitled to joining time for ________________ days.
8. The details to the Income Tax recovered from him up to the date from the beginning of the current year are noted
on the reserve.
REVERSE
Detail of Recoveries
Name of Recovery:- Amount Rs:- will be recovered from his gratuity.

Signature:___________________
Dated: Designation: H,M GHS BAKKI MANSEHRA
SPECIMAN SIGNATURES OF MR. MUHAMMAD SHOUKAT (HM 17)

1. __________________________ 2. __________________________

3. __________________________

Principal GHS BAKKI Mansehra

===========================================================================

THUMB & FINGER IMPRESSION OF MR. MUHAMMAD SHOUKAT (HM 17)

1. THUMB: …………………………………………….

2. FORE FINGER ………………………………………

1. MIDDLE FINGER …………………………………………….

4. RING FINGER ………………………………………

5. LITTLE FINGER …………………………………………

Attested

Principal GHS BAKKI Mansehra

===========================================================================
OPTION FORM FOR DIRECT CREDIT OF PENSION THROUGH BANK ACCOUNT
Pensioner’s information (To be filled in by Pensioner himself)

P.P.O No
Personnel No 00222937
Accounts office (From where P.P.O originally issued D.A.O
Name of Pensioner MUHAMMAD SHOUKAT
Father’s / Husband Name ABDUL JALEEL
Family Pensioner’s Name
Spouse’s / Father’s / Mother’s Name
Pensioner’s NIC (Old) No
Pensioner’s NIC No 13503-30208679-9
Family Pensioner’s CNIC No
Residential Address (Current) Village & PO Shinkari The:&Distt:Mansehra
Residential Address (Permanent) Village & PO Shinkari The:&Distt:Mansehra
Designation and Grade at the time of retirement HEAD MASTER BPS No 17
Ministry /Division / Deptt / Office Education Department
Present NBP Branch with Code NBP SHINKARI Mansehra (________)
I hereby opt to draw pension through direct credit system and have also submitted *Indemnity Bond / Lien
for six months to the bank.
The pensioner should produce an Indemnity Bond for aggregate amount equivalent to six months pension
jointly with the person who is account holder of the branch & acceptable to the Bank, dully supported by a
lien or deposit of securities of Indemnity bond’s account.
Provided that a pensioner may not execute Indemnity bond if he or she authorizes the bank to mark lien on
his/her account to the extent of six months pension, as is required from the co-indemnity.

Dated: _____________ (Pensioner’s signature / Thumb impression)

Account Verification (To be verified by the bank)

Account Title (Name) MUHAMMAD

SHOUKAT
Account No PLS-4950-2
Branch Name NBP SHINKARI
Mansehra
Branch Code
Indemnity Bond / Lien
submitted by pensioner
Signature with Stamp of Bank Manager

===========================================================================

Entries Verified Entered in SAP & Approved

With record Issued P. No ___________
Sr. Auditor A.A.O D.A.O

(Pension Cell) (Computer Lab) Mansehra

 NO DEMAND CERTIFICATE
Certified that nothing is outstanding against Mr. Muhammad Shoukat (HM) GHS BAKKI who has been

retired is retiring 30-04-2023 (AN) either on account of any Government Money or property and that is

anything is found later on, the name will be the responsibility of the undersigned.

HEAD MASTER GHS BAKKI Mansehra D.E.O (M) Mansehra

OPTION FOR COMMUTATION

I do herby option to commute my 35% pension as admissible under the rules.

Signature of Ex. Employee___________________

Designation: HEAD MASTER

HEAD MASTER

DECLARATION UNDER ARTICLE 911 C.S.R

REGARDING NON RECEIPT OF PENSION
I hereby certified that I have neither applied for nor received any pension or gratuity in r/o my portion of the
service included in the application and in r/o which pension or gratuity as claimed here in/non shall I submit any
application here after with our quotation a reference to his/her application and the orders which may be passed
there on.

Signature of Ex. Employee_______________

Designation: HEAD MASTER

HEAD MASTER
 DECLARATION
I hereby certified that I have neither applied for nor received any pension or gratuity in r/o my portion of the
service included in the application and in r/o which pension or gratuity as claimed here in/non shall I submit any
application here after with our quotation a reference to his/her application and the orders which may be passed
there on. Signature of Ex. Employee_______________

Designation: HEAD MASTER

HEAD MASTER

UNDERTAKING
Should the amount of pension / gratuity granted to me be after awards found to be in excess of that to which I
am entitle, under the rule I hereby undertake to refund my excess.

Signature of Ex. Employee_______________

Designation: HEAD MASTER

HEAD MASTER

UNDERTAKING FOR RECOVERY OF GOVERNMENT DUES

I do hereby undertake & give my consent to the recovery of any Government dues found outstanding against me
on account of Pay & Allowances or any other item of payment during service , from any gratuity , pension etc
admissible to me under the rules.

Signature of Ex. Employee_______________

Designation: HEAD MASTER

HEAD MASTER
 DECLARATION UNDER ARTICLE 920 (I) CSR
I do hereby declare that in case the amount of pension / gratuity sanctioned to me is found to be in excess of that

to which I am entitled to under the rules, I do hereby undertake to refund such excess, which called upon to do

so.

Signature of Ex. Employee_______________

Designation: HEAD MASTER

HEAD MASTER

CERTIFICATE REQUIRED UNDER CSR 922

Whereas I MUHAMMAD SHOUKAT S/O ABDUL JALEEL

Serving in Education Department at GHS BAKKI do hereby provisionally, option to advance me the sum
of Rs1361640 /- per month and a Lump-sum gratuity or Government to fix the amount of my pension &
gratuity. I hereby acknowledge that, in accepting this advance I fully understand that, my pension & gratuity is
subject to revision on the complication to the necessary formal enquires. I promise to raise no objection to such
revision on the ground that provisional pension & gratuity now to be paid to me exceeds the pension and
gratuity to which I may be eventually found entitled I further promise to repay any amount advanced to me in
excess of the pension & gratuity to which I may be eventually found entitled.

Signature of Ex. Employee_____________

Designation: HEAD MASTER

HEAD MASTER
 LIST OF FAMILY MEMBERS/LEGAL HEIRS
OF
Mr: MUHAMMAD SHOUKAT S/O ABDUL JALEEL BPS-17

Whether
S.No Name of Heir / Member Relation with Age Married OR
Pensioner
Un-Married

01 WIFE

02 EMMAN SHOUKAT DAUGHTER 12 YEARS UN MARRIED

03 SUDAIS SHOUKAT SON 10 YEARS UN MARRIED

04 MAHAM SHOUKAT DAUGHTER 7 YEARS UN MARRIED

05 SAAD SHOUKAT SON 5 YEARS UN MARRIED

SABIA SHOUKAT SON 3 YEARS UN MARRIED

I solemnly declare and affirms that the family members / heirs of (pensioner) Mr./Mrs
MUHAMMAD SHOUKAT is correctly as above.
I further declare that there is no family member other the mentioned above.

____________________________________
Signature / Thumb impression of pensioner
Attested
 CLEARING CERTIFICATE / UNDER TAKING FROM HEAD MASTER

Certified that MUHAMMAD SHOUKAT have remained in charge of this school w.e.f 1/9/1985 to 30/04/2023

The conditional grants granted for this school, as well as CRC/Petty repair fund , Construction of Boundary

Wall, Group Latrine, Water Scheme and Additional Rooms etc has been completed during my supervision

nothing is outstanding against me and I also affirm that any missing found here be after, it will be recovered

from my gratuity/ pension or GPF etc.

Signature of Govt. Servant who took charge from HEAD MASTER :_____________________________________

Name of Govt. Servant who took charge from HEAD MASTER MUHAMMAD SHOUKAT

Signature: __________________________

Name of Govt. Servant: MUHAMMAD SHOUKAT

Designation: HEAD MASTER

School / Circle: GHS BAKKI MANSEHRA

CNIC: 13503-0208679-9
Home Address: Village _______
P.O. _______________

Principal GHS BAKKI MANSEHRA

 LOAN ADVANC CERTIFICATE
It is to certified that Mr. MUHAMMAD SHOUKAT Ex-HM serving in Education Department has not
drawn any kind of loan advance i.e. HBA/MCA during in his service.

Signature of Ex. Employee_______________

HEAD MASTER

PAY STOPPAGE CERTIFICATE

Certified that Mr. MUHAMMAD SHOUKAT Ex-HM Personal No. 00222937 the officer/official has
retired from service 30-04-2023 after noon his pay not drawn after retirement as per record of this school.

HEAD MASTER

NON INVOLVEMENT CERTIFICATE

It is to certify that MUHAMMAD SHOUKATS/O ABDUL JALEEL Ex-HM BPS-17 working at

Govt: High School BAKKI Mansehra is not involved in any Departmental, Judicial, Anti-corruption or Police
case nor any such enquiry in line pending against him. He neither availed long leave nor joined nay other
department or organization.

HEAD MASTER