....... New Retiring Pension 01.07.2023 Muhammad Azam

2
N.DOB: 61 60
REAT: 148.4628 110050.00 X 7 X 30 = 77035.00

300
AGE
Years Months Days
60 11 30
SERVICE Gross pension: = 77035.00
35 4 12 35% commtt: = 26962.25
35 30 Net pension: = 50072.75
EP 2010 UPTO 3000/- = 0.00

M/A 2010 25% = 19258.75
M/A 2015 25% = 4814.69
COMMTT VALUE IIP 2022 15% = 7510.91
IIP 2023 17.5% = 16273.64
26962.25 X 148.4628 4002891 TOTAL AMOUNT = 97931
#REF!
TOTAL MONTH LEAVE TOT LEAVE

424 X 4 1696
Office Of the Head Master GHS Razmak
North Waziristan Tribal District
No._________/Pen dt____/____/2023
To:
District Accounts Officer,

NWTD Miranshah.
Subject: Superannuation Retirement Pension Claim In R/O Mr.Muhammad Azam

Khan Son of Lal Madar BPS 17 Ex SET Of Edu/deptt
1. Subject Superannuation Retirement pension claim alongwith orignal Service

Book and other connected document in respect of above named Pensioner is sent herewith for
issuance of pension payment order at an early date, please.
2. Servicee particulars of the pensioner are as under:-
a. D.O Birth 6/1/1963

b. D.O Entry 1/20/1988
c. D.O R 5/31/2023
d. Basic pay Scale 17
e. Total Service 35 Years
f. Pay Rate 110050
g. Gross Pension 77035.00
h. Pension paying Auth HBL Mir Ali
A/C 02167901230003
i. CNIC No. 21505-5723399-7
j. P/Number 50175051
Head Master GHS Head Master GHS

Razmak (NWTD) Garium (NWTD)
Office Of the Head Master GHS Razmak
NOTIFICATION
Due to completion of 35 Years Qualifying Service and 60 Years

Age Mr. Muhammad Azam Khan Son of Lal Madar Ex:SET Of Edu/deptt is hereby
retired from the service on Superannuation Retirement Pension with effect from // on
his own request.
He is also entitled for 365/- day’s encashment of Leave in lien of L.P.R.

Necessary entry should made in his service Book.
Head Master GHS

Garium (NWTD)
No. ______________/Pen Dated _______/_______/2023

Copy to:
1 The District Account Officer NW Miran Shah for Information.

2 Office File.
Head Master GHS

Garium (NWTD)
3
KHYBER PAKHTUNKHWA GOVERNMENT GAZETTE, EXTRAORDINARY 06th SEPREMBER, 2021
Pension Form - VI
[see rule 23(1),(7),(9),(11) & (14)]
APPLICATION /CERTIFICATES TO BE GIVEN BY THE PENSIONER FOR

PENSION/COMMUTATION.
(To be given by retiring civil servant for grant of pension in ease of
supcrannualion/retiring/invalid/compensation/compulsory retirement)
To
Head Master GHS

Garium (NWTD)
Sir/Madam,
It is submitted that I Mr. Muhammad Azam Khan Son of Lal Madar SET Of Edu/deptt BPS 17
DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-
7 Personal No.50175051 Nationality Pakistani Cell No.NIL Email NIL
That I has retied from Government service. I am due to retire on 31/05/2023. My
pension/commutation/gratuity may be transferred/ credited by the Accounts Office in the Bank Branch HBL Mir
Ali Account No. 02167901230003 DCS Form (where applicable) and list of my family members, is enclosed).
(Signature/Left hand thumb impression in r/o)

Muhammad Azam Khan Son of Lal Madar
CNIC NO. 21505-5723399-7
Head Master GHS

Garium (NWTD)
Head Master GHS

Razmak (NWTD)
1
PENSION CALCULATION STATEMENT CERTIFICATE
Pension calculation statement in respect of Mr. Muhammad Azam Khan Son of Lal Madar SET
Of Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC
No. 21505-5723399-7 Personal No.50175051 while proceeding on Superannuation Retirement Pension.
DOB: 6/1/1963 Pension 110050 X 7 X 30 = 77035.00

DOA: 1/20/1988 300
DOR: 5/31/2023
Q/S: 30 Years
AGE: 60 Years Gross pension: 77035.00
PAY: 110050 35% commtt: 26962.25
U/INC: 0 Net pension: 50072.75
TOTAL: 110050
CINC NO 21505-5723399-7 EP 2010 UPTO 3000/ 0.00
ADD:- Village Mulagan M/A 2010 25% 19258.75
Tehsil Mir Ali M/A 2015 25% 4814.69
SERVICE IIP 2022 15% 7510.91
YEARS MONTHS DAYS NET SER IIP 2023 17.5% 16273.64
35 4 0 30 Years TOTAL AMOUNT 97930.74
AGE
YEARS MONTHS DAYS N/DOB:
60 11 0 60 Years
COMMTT VALUE
26962.25 X 148.4628 = 4002891
ATTESTED
Head Master GHS

Garium (NWTD)
Head Master GHS
Razmak (NWTD)
2
LEFT HAND THUMB & FINGERS IMPRESSION
Left hand thumb & fingers impression in respect of Mr. Muhammad Azam Khan Son of Lal Madar
SET Of Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali
CNIC No. 21505-5723399-7 Personal No.50175051 while proceeding on Superannuation Retirement Pension.
Thumb Index Finger Middle Finger Rang Finger Little Finger
ATTESTED
Head Master GHS

Razmak(NWTD)
Head Master GHS

Garium (NWTD)
LIST OF FAMILY MEMBERS
Detail of list of Family members in respect of Mr. Muhammad Azam Khan Son of Lal Madar SET
Of Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC
No. 21505-5723399-7 Personal No.50175051 while proceeding on Superannuation Retirement Pension
S No. Name Relation Age/Birth Marrage/Un Marrage

1 Shamula Bibi WIFE 2/3/1968 WIFE MARRIED
2 Hassina 1/4/2001 WIFE MARRIED
3 Wajid Ullah 1/1/1985 MARRIED
4 Arfan Ullah 6/8/1905 MARRIED
5 Amjid Khan 19/8/1990 UN MARRIED
6 Hemayat Ullah 1/1/1997 UN MARRIED
7 Sunila 14/10/2001 UN MARRIED
8
9
10
11
12
ATTESTED
Head Master GHS
Garium (NWTD)
Head Master GHS

Razmak (NWTD)
SPECIMENS SIGNATURE
Specimens signature in respect of Mr. Muhammad Azam Khan Son of Lal Madar SET Of
Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC
a. b. c.
ATTESTED
Head Master GHS

Head Master GHS Razmak (NWTD)
Garium (NWTD)
UNDERTAKING CERTIFICATE
I hereby undertake that in case of pension increase in the pension terms to be more than increase
that may admissible to me will be deducted from my further payment of pension.

ATTESTED CNIC NO. 21505-5723399-7

Garium (NWTD) Razmak (NWTD)
DECLARATION IN SUPPORT OF PENSION CLAIM
I hereby declare that I have neither applied for nor received any pension or gratuity in respect of any
portion of the service included in this application and in respect of which pension or gratuity is claimed herein,
not shall I submit an application hereafter without quoting a reference to this application and the orders which
may passed thereon.

CNIC NO. 21505-5723399-7
ATTESTED CNIC NO. 21505-5723399-7

4
PENSION COMMUTATION CERTIFICATE
I hereby option to commute 35% of my pension in term of Government of Pakistan Finance Division
ltr No F.1 (2)/Imp/2005 dated 1st Jul 2005.

ATTESTED Muhammad Azam Khan Son of Lal Madar
CNIC NO. 21505-5723399-7

NON INVOLVEMENT CERTIFICATE.
it is certified that Mr. Muhammad Azam Khan Son of Lal Madar SET Of Edu/deptt BPS 17
7 Personal No.50175051 has neither involved in any disciplinary/Departmental/Anti-Corruption/Judicial case
nor any penalty has imposed against him under the relevant rules during his previous Service.

CNIC NO. 21505-5723399-7

OPTION CERTIFICATE
It is hereby opted to draw may pension from the HBL Mir Ali A/C No:-
02167901230003

CNIC NO. 21505-5723399-7
Head Master GHS
Garium (NWTD)
Head Master GHS

Razmak (NWTD)
5
NO DEMAND CERTIFICATE
Certified that nothing is outstanding against Mr. Muhammad Azam Khan Son of Lal Madar SET Of
ATTESTED
Head Master GHS

Garium (NWTD)
LIFE CERTIFICATE
Certified that I have seen Mr. Muhammad Azam Khan Son of Lal Madar SET Of Edu/deptt
BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC No. 21505-
5723399-7 Personal No.50175051 is proceeding on Superannuation Retirement Pension is alive on this date
ATTESTED

BENEVOLENT FUND AND (RB & DC) FUND REGULAR CONTRIBUTION CERTIFICATE
7 Personal No.50175051 was a permanent employee of the provincial Government of K.P.K and was a regular
contributor to the Benevolent Fund, and (RB & DC Fund) from the date of his appointment till his Retirement @
the Rate of scale deduction
ATTESTED
Head Master GHS

Garium (NWTD)
Head Master GHS

Razmak (NWTD)
6
NO HBA/MCA CERTIFICATE
7 Personal No.50175051 has not availed any advance i.e. house building advance Motor cycle advance etc
during his service till retirement.
ATTESTED
Head Master GHS

Garium (NWTD)
NON PAYMENT CERTIFICATE OF LEAVE DURING LAST 12 MONTHS

7 Personal No.50175051 has not been paid leave Encashment nor availed any kind of leave during last 12
months.
ATTESTED

PAY STOPPED CERTIFICATE
it is certified that the salary of Mr. Muhammad Azam Khan Son of Lal Madar SET Of
No. 21505-5723399-7 Personal No.50175051 pay has been stopped WEF 27/03/2024
ATTESTED
Head Master GHS

Garium (NWTD)
Head Master GHS

Razmak (NWTD)
1
255 KHYBER PAKHTUNKHWA GOVERNMENT GAZETTE, EXTRAORDINARY 06th SEPREMBER, 2021
EXTRAORDINARY REGISTERED NO. Rlll
GOVERNMENT GAZETTE
KHYBER PAKHTUNKHWA
Published by Authority
PESHAWAR, MONDAY, 06th SEPTEMBER, 2021.
GOVERNMENT OF KHYBER PAKHTUNKHWA FINANCE DEPARTMENT
PENSION PAPERS
Name: Muhammad Azam Khan

Father/Husband Name: Lal Madar
CNIC No. 21505-5723399-7
Designation SET Of Edu/deptt
Personal No: 50175051
Date of Retirement 31/03/2024
3
PENSION SANCTION ORDER TO BE USED IN CASE OF

SUPERANNUATION/RETIRING/INVALID/ COMPENSATION/COMPULSORY
RETIREMENT
('I'o be issued by the Pension Sanctioning Authority)
Subject: Sanction of Pension Superannuation Retirement
On attaining the age of superannuation/having applied for retiring/invalid/compensatory

pension vide application dated____________Or has been retired compulsorily vide
Notification/Order No. ______ Dated_________issued by
Mr/Mrs/Ms Muhammad Azam Khan S/O Lal Madar Ex: SET Of Edu/deptt pay/emoluments
Rs 110050/- (reckonable towards Pension) In BPS 17 (Please Indicate nature of appointment i.e.
Regular/Officiating or Acting charge w.e.f 20/01/1988 Personal No. 50175051 CNIC No. 21505-5723399-7
presently posted as SET Of Edu/deptt has retied on 31/05/2023 date availing LPR for 365 days / Leave
encashment in lieu of LPR Rs._______________
PENSION CALCULATION
Gross Pension = 77035.00
35% Commutation = 26962.25 COMMTT VALUE
65% Net Pension = 50072.75 26962.25 X 148.4628 4002891
OTHER BENEFITS
EP 2010 UPTO 3000/- 0.00 TOTAL MONTHLY
M/A 2010 25% 19258.75 PENSION
M/A 2015 25% 4814.69 97931
IIP 2022 15% 7510.91
IIP 2023 17.5% 16273.64
TOTAL AMOUNT 97930.74
(1) His/her date of birth is 01/06/1963 Date of 1st entry onto government service is 20/01/1988 and EOL
availed ____________days total length of qualifying service is (35 years) (4 months) (12 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 Advance drawn (if any) stand fully repaid along with interest
ii An amounting of Rs.______ on account of _________(HBA/MCA/etc) principal amount
along with interest is outstanding witch may be recovered from the pension
(5) Anticipatory pension upto _______% of full pension is sanctioned as admissible to him/her.
(6) Certified that deficiency / disciplinary / criminal case 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 35%of gross pension ) as determined by
concerned Accounts Office may be paid.

Razmak (NWTD) Garium (NWTD)
2
UNDERTAKING
1. I 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 with in one year from the issue of Pension
Payment Order recover any of its dues from the pension granted to me.
3. I hereby declare that I shall not take part in any election or engage my self political activity of
any kind within two year from the date of retirement.
4. I do declare that I have neither for nor received any pension/commutation/gratuity in respect
of any portion of the service included in this application and respect of which pension/gratuity is
clamed 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 hereby undertake to refund if the amount of pension granted to me afterward found to be in

excess of that to which I am entitled under the regulation.
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 opt for commutation @ 35% (subject to a maximum of 35%) of my gross pension
Dated______/______/2023
Signature of Muhammad Azam Khan

Designation SET Of Edu/deptt BPS 17
Certificate by the head of department under sub rule (7) of rule 23 of these rules
Head Master GHS

Razmak (NWTD) Head Master GHS
Garium (NWTD)
Note: Pension to be verified by pension sanctioning authority/DDO Important: Every

pensioner/family pensioner is bound to provide life certificate/Non- marriage certificate to
his/her bank on or before 10th March and 10th September of each year.
4
(7) Undersigned is satisfied that the service of employee has been satisfactory. Administrative
and financial sanction for grant of pension / Commutation 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 Azam Khan through bank HBL Mir Ali Account No.
02167901230003 as admissible under the rules.
(7a) Undersigned is satisfies that the service of Mr/Mrs/Ms

________________________________ has not been satisfactory and it has been decided that
the full pension / gratuity found to the Audit / Account Office to be admissible under the rules
should be reduced by the specific amount of percentage given below.
i Amount of percentage of reduction in pension____________________

ii Amount or percentage of reduction in gratuity/commutation________
Sanction is hereby accorded to the grant of pension/gratuity/commutation as so reduced.
9) . The payment of pension and/or gratuity/commutation may commence wef 01/06/2023
Following Documents attached
1 Pension application.
2 Notification/Order of retirement.
3 Last Pay Certificate(LPC)/Last Pay Slip
4 Pension contribution certificate in case of foreign service
5 Original Service Book with its attested copy or service statement in case of officers.
6 NOC from Estate Office in case the civil servant was provided government accommodation
otherwise a certificate by the civil servant that he has not been provided the government
accommodation.
7 Three attested photographs of the pensioner
8 List of dependent family members
9 Specimen signature/ Left and Right hands thumb and finger impressions.
10 Option for commutation.
11 Bank account’s details.
Pension Sanctioning Authority Head Master GHS

Garium (NWTD)
OPTION FORM FOR DIRECT CREDIT OF PENSION THROUGH BANK ACCOUNT
Pensioner Information (To be filled in by the Pensioner)
PPO No.
SAP Personnel No. P/NUMB:- 50175051
Accounts Office (From where PPO originally issued) District Accounts Office Miranshah
Name of Pensioner Muhammad Azam Khan
Father/Husband Name Lal Madar
Family Pensioner Name
Spouse/Father/Mother Name
Pensioner NIC old#
Pensioner CNIC # 21505-5723399-7
Family Pensioner CNIC#
Residential Address (Current) Village Mulagan Tehsil Mir Ali
Residential Address (Permanent) Village Mulagan Tehsil Mir Ali
Designation & Grade at the time of Retirement SET Of Edu/deptt BPS 17
Ministry/Division/Deptt./Office Head Master GHS Garium (NWTD)
Present NBP Address & Code No.

I hereby opt to draw pension through direct credit system and have also submitted
*Indemnity Bond to the bank.
*The Pensioner shall produce an Indemnity Bond to keep the bank indemnified about liabilities with all sums of money
whatsoever including mark-up of his/her Pension Account. The pensioner would further undertake that his/her legal heirs,
successors, executors shall be liable to refund excess amount, if any, credited to his/her Pension Account either in full or
in installments (as agreed mutually) equal to such excess amount__
Pensioner’s Signature/Thumb Impression
Dated ______/_____/2023
Account Verification (To be verified by the Bank)
Account Title (Name) Muhammad Azam Khan
Account No. 02167901230003
Branch Name/Address HBL Mir Ali
Branch Code HBL Mir Ali
Indemnity Bond/Lien submitted by the Pensioner Signature/Stamp of Bank Manager
------------------------------------------------------------------------------------------------------------------------------------------------------------
To be issued by Accounts Office
Acknowledgement Receipt No.___________ Signature of Officer__________
Date_____________
INDEMNITY BOND
To
The Manager,
____________________(Name of Bank)
____________________ (Branch)
____________________ (City)
In compliance with the SBP’s instructions for payment of pension through

your Bank branch I agree to indemnify you and keep you indemnified about liabilities with
all sums of money whatsoever including mark-up of my Pension Account. I further
undertake that my legal heirs, successors, executors shall be liable to refund excess
amount, if any, credited to my Pension Account either in full or in installments equal to such
excess amount.
Co-Indemnifier/Nominee/Successor/ Signature______________________
Next of Kin:__________________________ Name of Pensioner Muhammad Azam Khan
CNIC: ______________________________ Date of Retirement: 5/31/2023
Address:_____________________________ PPO No:______________________
Signature: ___________________________ Bank Account No: 02167901230003
CNIC: 21505-5723399-7
Witness –I Witness-2
CNIC:______________________________ CNIC:________________________
Signature:___________________________ Signature:_____________________
Date:_______________________________ Date:_________________________
NAME Mr. Muhammad Azam Khan SET Of Edu/deptt
Of the Head Master GHS Garium (NWTD)
Proceding to Superannuation Retirement
He/She has been paid upto 30/092023
as the following rates:-
Pay and Allowances:-

0001:- Basic Pay 0
1001:- HR ALLOW 2187
1210:- Convince Allowance 1785 P/NUMB:- 50175051
1300:- MEDICAL ALLOW 1500
1528:- UAA 1000 CNIC NO.21505-5723399-7
2013 Ad-hoc Relief Allow 15% 475
2015 Ad-hoc Relief Allow 10% 333
2311:- W/Allow 1000
2312:- Dress Allow 1000 Deductions:-
2313:- Integr: Allow: 600 GPF 830.00
SPL / Teasching Allow 0 GPF Adv: 0.00
2016 Ad-hoc Relief Allow 10% 0 Incme Tax 0.00
2017 Ad-hoc Relief Allow 10% 0 BF 300.00
2018 Ad-hoc Relief Allow 10% 0 EEF 60.00
2019 Ad-hoc Relief Allow 10% 0 D&R Comp 451.00
2021 Ad-hoc Relief Allow 10% 0 Total Ded 1641.00
2341:- DRA 2022 15% 0
2347:- 2022 ADH Allow 15% 0
0000:- 2023 ADH Allow 17.5% 0
GrossTotal 9880
He made over charge of the office of Head Master GHS Garium (NWTD) on the //
Recoveries are to be made from the pay Government Servant as detailed on the below,
Name of recovery________________________________________Amount Rs._______________
To be recovered to __________________________________________________instalments
Head Master GHS

Garium (NWTD)
CLEARNCE CERTIFICATE
it is certified that nothing out-stinging rent against Mr. Muhammad Azam Khan
Son of Lal Madar SET Of Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR,
31/05/2023 village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-7 Personal No.50175051 ,
since there is no Government residence in this use.
Dated:____/____/_____
Sub Divisional Officer

Building Division Miran Shah
CLEARNCE CERTIFICATE
it is certified that nothing out-stinging rent against Mr. Muhammad Azam Khan
Son of Lal Madar SET Of Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR,
31/05/2023 village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-7 Personal No.50175051 ,
since there is no Government residence in this use.
Dated:____/____/_____
Sub Divisional Officer

Building Division Miran Shah
CLEARENCE CERTIFICATE PTCL
it is certified that nothing out-Standing against Mr. Muhammad Azam Khan Son
of Lal Madar SET Of Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023
village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-7 Personal No.50175051 of Telephone
department, Miran Shah N.W.
A.B.M (Operration)
PTCL NWTD Miran Shah
CLEARENCE CERTIFICATE PTCL
it is certified that nothing out-Standing against Mr. Muhammad Azam Khan Son
village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-7 Personal No.50175051 of Telephone
department, Miran Shah N.W.
A.B.M (Operration)
PTCL NWTD Miran Shah
CLEARENCE CERTIFICATE TESCO
it is certified that nothing out-standing against Mr. Muhammad Azam Khan Son
village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-7 Personal No.50175051 of TESCO
(Wapda) N.W.
Dated:____/____/_____
Revenue Officer
TESCO Division Miran Shah
CLEARENCE CERTIFICATE TESCO
it is certified that nothing out-standing against Mr. Muhammad Azam Khan Son
village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-7 Personal No.50175051 of TESCO
(Wapda) N.W.
Dated:____/____/_____
Revenue Officer
TESCO Division Miran Shah
NON PAYMENT CERTIFICATE OF LEAVE DURING LAST 12 MONTHS
it is certified that Mr. Muhammad Azam Khan Son of Lal Madar SET Of Edu/deptt BPS
17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC No. 21505-
5723399-7 Personal No.50175051 has not been paid leave Encashment nor availed any kind of leave
during last 12 months.
ATTESTED VERIFIED
Head Master GHS District Accounts Officer

Garium (NWTD) NWTD Miran Shah
PAY STOPPED CERTIFICATE

it is certified that the salary of Mr. Muhammad Azam Khan Son of Lal Madar SET Of
Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali
CNIC No. 21505-5723399-7 Personal No.50175051 pay has been stopped WEF 27/03/2024
ATTESTED VERIFIED

30 YEARS QUALIFYING SERVICE CERTIFICATE

Mr. Muhammad Azam Khan Son of Lal Madar SET Of Edu/deptt BPS 17 DOB,
01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-
7 Personal No.50175051 has already completed 30 years qualifying service on the basic of servic
everification already recored in his service book as well other record of this office.
ATTESTED VERIFIED
District Accounts Officer

Head Master GHS NWTD Miran Shah
Garium (NWTD)
NON INVOLVEMENT CERTIFICATE
it is certified that Mr. Muhammad Azam Khan Son of Lal Madar CNIC NO. 21505-
5723399-7 SET Of Edu/deptt BPS 17 Personal Number 50175051 Village Mulagan Tehsil Mir Ali has
neither involved in any disciplinary/Departmental/Anti-Corruption/Judicial case nor any penalty has
imposed against him under the relevant rules during his Service.
ATTESTED
Head Master GHS

Jan Muhammad Kot (NWTD)
NO BRAKE IN SERVICE/LEAVE CERTIFICATE
Mr. Muhammad Azam Khan Son of Lal Madar SET Of Edu/deptt BPS 17
DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC No.
21505-5723399-7 Personal No.50175051 there is no bracke in his service and not availed any
kind of leave in his entire service and also qualified his service duration successfully till retirement
ATTESTED
Head Master GHS

NO DEMAND CERTIFICATE
Certified that nothing is outstanding against Mr. Muhammad Azam Khan Son of Lal
Madar SET Of Edu/deptt BPS 17 DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village
Mulagan Tehsil Mir Ali CNIC No. 21505-5723399-7 Personal No.50175051 while proceeding on
Superannuation Retirement Pension.
ATTESTED

Head Master GHS

APPLICATION FOR LEAVE.
NOTE:- Items 01 to 09 must be filed in by all applicants. Item 12 applies only in case of
Govt: Servant of BPS-16and above.
1 Name of Applicant. Muhammad Azam Khan

2 Personal Number.
3 Leave Rules applicable. Revised leave rules1981
4 Post Held. SET Of Edu/deptt BPS 17
5 Department. Head Master GHS Garium (NWTD)
6 Institution.
7 House Rent/Conveyance and Regular allow
drewn in the present post. Yes
8 (a) Nature of Leave applied for. Leave Encashment
(b) Period of Leave in Day. 365 Days
(c) Date of Commencement.
9 Particular Rule/Rules Under which leave admissible. Leave 1981
10 (a) Date of Return for last leave.
(b) Nature of leave.
(c) Period of leave in day.
Signature of applicant. Muhammad Azam Khan
11 Remarks recommendation of the controlling Officer.

Certified that the leave applied for as admissible under the rule 1981, and necessary
condition are fulfilled.
Head Master GHS

Garium (NWTD)
12 Report of the Audit Officer.

Head Maste GHS NWTD Miran shah
CONSOLIDATE CLEARANCE CERTIFICATE
Note:- This certificate be added to pension case in duplicate consolidate clearance certificate in
R/O Muhammad Azam Khan S/O Lal Madar
It is certified that:-
1
The service reduce by the above named applicant was under the Government and was
pensionable.
2
There is no break deficiency interruption or Foreign service which could not be regularized.
3
Pension as well as pension commutation mentioned in the application have been checked and
found correct as per standing rules and regulation of Government.
4.(a) No Departmental enquiry/Legal proceedings is pending against the applicant. Nothing is

outstanding against him.
(b)
A cases of enquiry/Legal proceeding is/are in progress against the application as per detail in
the attached sheet in case full detail be attached under the signature of the IE with clarification
as to way the pension bill has been recommended on the superannuation retirement.
5
No Government dues like Income Tax House Rent etc outstanding the applicant.
NOTE:- In case of any exemption or disputed please add the detail

separate sheet with clarification on justification of recommendation of the
pension paper.Nothing is outstanding against him.
6 N.D.C N.I.C
_______________________________
Name and signature of applicant
Muhammad Azam Khan S/O Lal Madar
Name and signature of DDO

With office Stamp Head Master GHS
Garium (NWTD)
Countersignature of Director
With office Stamp
Head Master GHS
To,
The Director Education

(NMD) FATA Khyber Pakhtunkhwa
Peshawar
Through Proper Channel
SUBJECT:- Application for Superannuation Retirement and Leave Encashment

365 Days.
R/Sir,
With due respect I beg to state that I will proceed on superannuation pension
wef 31/05/2023 due to attaining the age of superannuation ie 60 years .My date of birth as per
service Documents is 01/06/1963 .I have not availed any kind of earned leave during last 12
months.
It is therefore requested that I may kindly be granted sanction of superannuation
pension wef 31/05/2023 and encashment of LPR of 365 days leave application duly verified
and signed by the District Accounts Officer miranshah is enclosed for ready reference.
Yours Obediently
_______________________________________
Muhammad Azam Khan S/O Lal Madar
SET Of Edu/deptt
Office of the Head Master
GHS Garium (NWTD)
No._______/LPR dt____/____/2021
To:
The Director Education

(NMD) FATA Khyber Pakhtunkhwa
Peshawar
Subject: Application for Superannuation Retirement and Leave Encashment

365 Days.
Memo;
An application for grant of Superannuation Retirement and leave

encashment 365 Days in R/O Mr. Muhammad Azam Khan SET Of Edu/deptt is
forwarded herewith for further process at your end please.
Head Master GHS

Garium (NWTD)
OFFICE OF THE DISTRICT ACCOUNTS OFFICER NW MIRAN SHAH
No. DAO/MRN/GAD/2023-24/ Dated_____/______/2023
HISTORY OF SERVICE
Name Muhammad Azam Khan F/Name Lal Madar

Date of Birth 6/1/1963 Religion Islam
Mother
Date of Appointment 1/20/1988 Tongue Pashto
Joined Service 1/20/1988 BPS 17
Computer No. 50175051 GPFNo
N.I.C. No. 21505-5723399-7
Duty/
Period Leave etc
Post Held BPS Department / Station From To Remarks
NWTD Miran Shah
Head Master GHS

OFFICE OF THE DISTRICT ACCOUNTS OFFICER NWTD MIRAN SHAH

No. DAO/MRN/GAD/2023-24/ Dated_____/______/2023
To,
For Pension Purpus
Subject: LPC,Service Statement/Documents in R/O Mr. Muhammad Azam Khan
Son of Lal Madar SET Of Edu/deptt BPS 17 Personal Number 50175051
Consequent upon the Retirement of the above named officer to/on //.
His/Her LPC,Service Statement and Personal File are sent herewith for necessary action.
He/She has been / will be paid upto // at the following rates:
PAYMENT DEDUCTION
PAY G.P.FUND
PP I/TAX
HRA B/Fund
UAA EEF
M/A RB&DC
C/A HBA
Char All: MCA
STA Addl::GIF
HPA Total
ARA 2013
ARA 2015
Teaching
Disp 2022 GPF A/C No._______________________________
ARA 2022
ARA 2023
Total
1. He/She is authorized to draw pay and allowances from________________ to _______________at the above ra
2. Over payments of pay and allowances from ______________ to ____________ are recoverable at the above ra
3. Handed over charge on // Fore/After noon.
4. Availed leave from _________________________________ to _____________________________________
5. T.T.A advance of Rs.___________________________ is recoverable.
6. Service Statement prior to ________________ He/She was under the audit jurisdiction of ________________

NWTD Miran Shah
Head Master GHS
Office of the Head Master GHS

No._______/certifi dt____/____/2023
To:

NWTD Miran Shah
Subject: ISSUANCE OF VARIOUS CERTIFICATE.
Memo;
It is brought to your kind information that Mr. Muhammad Azam Khan
Son of Lal Madar SET Of Edu/deptt BPS 17 bearing CNIC No. 21505-5723399-7 and
personal number 50175051 Mulagan Tehsil Mir Ali District North Waziristan Tribal
District has been retired from Government Service on Superannuation retirement on
31/05/2023 for which the following certificate are essential.
1.History of Service.
2.Last Payment Certificate.
3.Attested Payroll/Pay Slip.
4.Qualifying Service Certificate.
5. Admissibility report on leave Application.
Head Master GHS

GHS Garium (NWTD)
No._________/D&R dt____/____/2024
To:
The Project Manager,

Retirement Benefit and Death Compensation
1st Floor Directorate of Treasuries & Accounts,
Khyber Pakhtunkhwa Peshawar.
Subject: GRANT OUT OF RETIREMENT BENEFIT AND DEATH COMPENSATION FUND.
Memo;
Enclosed please find herewith an application form for the grant of the
grant out of Retirement Benefit and Death Compensation fund in respect of Muhammad
Azam Khan Ex:- SET Of Edu/deptt BPS No, 17 is hereby retired from service on
31/05/2023, along with all connected documents is submitted for further process please.
Head Master GHS

Garium (NWTD)
Application Form
RETIREMENT BENEFIT AND DEATH COMPENSATION FUND
PAYMENT OF RETIREMENT BENEFIT
PART - I
1 Personal # 50175051
2
a) Name of Beneficiary Muhammad Azam Khan
b) CNIC No. - - 21505-5723399-7
c) Father / Husband Name Lal Madar
d) Last Position held SET Of Edu/deptt BPS 17
alongwith BPS
e) Name of Department Education Department
f) Station/Place of last Posting GHS Garium North Waziristan
dd mm yyyy
3 Date of Birth - - 01
9 - 06
3 - 1963
4 Date of Appointment - - 09 - 04 - 1986
5 Date of Retirment OR removal from 31 - 05 - 2023
service on account of
a) Superannuation / b) Dismissal from Service c) Removal
Qualifying service
d) Termination e) Resignation (Tick the relevant box)
6 Regular Contributions to
a) Group Insurance From To
b) RB&DC From 4/9/1986 To 31/05/2023
c) Missing period in case of I From To

leave without pay etc. i ii From To
iii From To
7 Address
a) Present/Postal Villege Mulagan Tehsil Mir Ali Distt: North Waziristan
____________________________________________________________________
b) Permenant Villege Mulagan Tehsil Mir Ali Distt: North Waziristan
c) Contact No. NIL
Muhammad Azam Khan

Signature or Thumb Impression
of Beneficiary
Page 1 of 2
Application Form
RETIREMENT BENEFIT AND DEATH COMPENSATION FUND
PAYMENT OF RETIREMENT BENEFIT
8 Bank Detail
a) Name of Bank HBL Mir Ali b) Bank Code 1806
c) Title of Account Muhammad Azam Khan
d) Type of Account (i.e. PLS, Saving, Current)
d) Account No 02167901230003
Signature of Branch Manager Stamp with Branch Code
PART-II
CERTIFICATE
1 Certified that the information contained above in respect of Mr/Miss/Mrs Muhammad Azam Khan is correct
and according to our record.
2 Certified that the above named employee was neither a contingency/work charged/adhoc/contract employee nor a
deputationist from any Provincial Government or Federal Government and he/she was a regular contributor of RB&DC &
Group Insurance Funds
3 Certified that the claim has been submitted for the first time and had never been sent previously from any office of this
department.
4 Certified that this department reserve the right to refund the amount of all grants sanctioned under RB&DC scheme, in case
of fake/fictitious documents / information in respect of the above named employee.
Dated________________________
Forwarded to the Board of Retirement Benefit & Death Compensation Fund, Finance Department Peshawar for grant
of retirement benefit
Dated________________________
Required documents & Instructions for submission of Application Form
a The application form must be countersinged by the concerned Head Administrative Department / Head of Attached Department
b Attested Photocopy of Retirement Order / Notification
c One Photograph of the beneficiary
d Attested photocopy of CNIC of beneficiary
e Leave account duly signed by the DDO, in case of Gazzetted be issued by the AG/DCA/DAO/AAO(s)
f Computerized pay slip showing RB&DC deduction, Pay stoppage certificate duly signed by the office of the DDO/AG/DCA/DAO/AAO(s)
g Attested Photo copy of first and 2nd page of S/Book, In case of Gazzetted a Service Certificate be issued by the AG/DCA/DAO/AAO(s)
h A copy of the Medical Board proceedings duly attested by the Head of Department.
i The attached docments should be marked as Annexure A, B, C etc
j Forward application form with covering Letter to:
Project Manager (RB&DC), 1st Floor Directorate of Treasuries & Accounts, Khyber Pakhtunkhwa
Peshawar
Page 2 of 2
2
FORM (10) FINAL PAYMENT OF G.P.FUND.
Office of the Head Master GHS Garium (NWTD)

3
1 Nmae of subscriber. Muhammad Azam Khan

2 Father name. Lal Madar
3 Designation SET Of Edu/deptt
4 GPF:AC:No:
5 Actual Date of Retirement 5/31/2023
6 In case of Resign Inviled/Rtd/Death. 5/31/2023
7 P/NUMBER 50175051
8 Total Balance of Balance Sheet.
9 P.O.No & dt: of last Deduction.
10 Treasury/Bank at which payment HBL Mir Ali Aaccount No. 02167901230003
will be made.
Head Master GHS

Garium (NWTD)
Endst: No_____________/GPF/Final Payment Dated _____/_____/2023
Copy forwarded to District Account Officer NW Miran Shah for further

necessary action please.
Head Master GHS

Garium (NWTD)
FORM: PAYF06
Date 1
Page No. 2
PERMANENT LOAN FORM (NEW & AMENDMENT)
Office of the Head Master GHS Garium (NWTD)

3
FOR THE MONTH4 OF 5/14/2024

GENERAL INFORMATION
DDO Code 5 Description
MW SET Of Edu/deptt
6
(Cost Center)
Personnel Employees
50175051 Muhammad Azam Khan 17
9
Number 7 Name Grade
10
National ID Designation Description
11A 12
Card Number 21505-5723399-7 Code
Scale Period of Old GP Fund

13 17 14 15 16
Service Account No.
PERMANENT LOAN DETAILS
18
Date of Permanent Total GROSS AMOUNT ¢
17
Loan / / Amount = 2.5% ZAKAT ¢
19
DD MM YYYY NEL BALANCE ¢
6/1/1963 5/31/2023
20 21
Date of Birth Date of appointment
Head Master GHS

Garium (NWTD)
General Providant Fund Claim Verfication Proforma (GCVP)
Cost Center MW DESCRIPTION GP FUND FINAL PAYMENT
Personal Number : 5 50175051 Name: Muhammad Azam Khan
GPF Account Number : 50175051
Bank Name
Bank Account Number HBL Mir Ali 02167901230003
Serial Number of Fund Payment Control Register
Head Master GHS

Garium (NWTD)
GHS Garium (NWD)
No._________/B/FUND dt____/____/2024
To:
The Director ,
Elementray and Secondary Education
KPK Peshawar
Subject: GRANT OUT OF BENEVOLENT FUND.
Memo;
Enclosed please find herewith an application form for the grant of the grant out
of Benevolent Fund in respect of Muhammad Azam Khan Ex:- SET Of Edu/deptt BPS No, 17 is
hereby retired fron service on Superannuation Retirement Pension on 31/05/2023, along with all
connected documents is submitted for further process please..
Head Master GHS

Garium (NWTD)
APPLICATION FORM FOR THE GRANT OF AID OUT OF K.P.K GOVERNMENT
SERVANT BENEVOLENT FUND PART-I & PART-II.
1 Name of Government Servant Late Muhammad Azam Khan

2 Designation & pay Scale SET Of Edu/deptt BPS 17
3 Date of Birth 6/1/1963
4 Date of entry into Government Servant 1/20/1988
5 Date of Retirement 5/31/2023
6 CNIC No of Pensioner 21505-5723399-7
7 Detail of Family Members
S No. Name Relation Age/Birth Married/Un Married

1 WIFE
2
3
4
5
6
7
8
9
10
11
12
8 Contact No NIL
9 Payment Option (Tick One) National Saving I Bank Name & Add:
Cross Cheque Certificate ii Branch Code:- HBL Mir Ali
iii Account # 02167901230003
I do hereby solemnly affirm and verified that the contents of the above application are
time to the best of my knowledge and nothing has been concealed.
I know that in the event of making a willful misrepresentation of suppression of fact I

shall be liable to criminal prosecution.
Signature of the applicant________________________

Name of the Applicant Mr.Muhammad Azam Khan
Address Vill Mulagan Tehsil Mir Ali NWA
I certify and attest the details furnished above on the record available in this office.
In case of Government Servants in In case of Government Servants in BPS-

BPS-1 to BPS-15 16 and above including Non-Gazetted
Staff of Civil Secretariat
Head Master GHS

Garium (NWTD)
Office of the Head Master GHS
Garium (NWTD)
No._________/EEF dt____/____/2024
To:
The Managing Director,

Education Employee Foundation,
K.P.K Peshawar.
Subject: GRANT OUT OF EDUCATION EMPLOYEE FOUNDATION
Memo;
Enclosed please find herewith an application form for the grant of Aid
out of Education Employee Foundation in respect of Muhammad Azam Khan Ex:- SET Of
Edu/deptt BPS No, 17 is hereby retired fron service on 31/05/2023, along with all
connected documents is submitted for further process please..
Head Master GHS

Garium (NWTD)
Head Master GHS
EDUCATION EMPLOYEE FOUNDATION

KHYBER PAKHTOONKHWA PESHAWAR
Office Building of Directorate General Commerce Education & Management Sciences
Rono Garhi Chamkani Chowk GT Road Peshawar, Phone No. 091-2614257
E-mall: eefkpk@gmail.com Facebook.com/EEF.kp Twitter.com/kp_EEF
APPLICATION FORM FOR THE GRANT OF RETIREMENT RELIEF
1. Name of Employee. Muhammad Azam Khan 2. Father's Name. Lal Madar
3. CNIC (Employee) .21505-5723399-7 4. Designation.SET Of Edu/deptt .5. BPS 17
6. Directorate . DE E &SE Khyber Pakhtunkhwa Peshawar
7. Date of Birth. // 8. Date of Appointment. //
9. Date of Retirenment/Death. // 10. Nature of Retirement. Superannuation Retirement
11. Place of Posting at the time of retirement. ____________________________________
12. Retirement/Leaving Service Order No.______________________ Dated.____/____/2023
13. Name of Legal Heir (in case of Death)___________________ 14.Relation. _________________
15. CNIC of (Legal Heir).___________________________ 16. EEF Registration No. (Attached Slip)__________
17. Contact Personal: (phone)____________________________ (Mobile)___________________________
18. Postal Address: Home No. District Education Office Miran Shah NWTD
Mohalla/Village Mulagan P/O Mir Ali
Tehsil Mir Ali District Morth Waziristan Tribal District
NOTE: The Following attested Documents must be attached with:

1 CNIC and service Card (photo Copy)
2 List of Famil Mumber
3 Death Certificate and CNIC of Legal Heir (in case of Death of the Employee)
4 Last Pay Certificate or pay Slip (Showing EEF Fund Desuction)
5 Notification/Office Order of Retirement (photo copy)
Signature/Thumbe Impression of applicant

Mr Muhammad Azam Khan Signature__________________________
Thumbe Impression ______________________
Head Master GHS

Garium (NWTD)
Bank Account Verification (To be verified by the Bank)
Account Title (Name) Muhammad Azam Khan

Account No. 02167901230003
Branch Name/Address HBL Mir Ali
Branch Code HBL Mir Ali
Signature/Stamp of Bank Manager

REGULAR CONTRIBUTOR OF EEF DEDUCTION CERTIFICATE.
it is certified that Mr. Muhammad Azam Khan S/O Lal Madar SET Of Edu/deptt BPS 17
Village Mulagan Tehsil Mir Ali was a regular contributor of Education Employees Foundation deduction
wef date of 1st appointment till retirement
ATTESTED
Head Master GHS

FORM: PAY02
PAYROLL SYSTEM
AMENDMENT FORM Date 1
SINGLE EMPLOYEE ENTRY

Page No. 2
3 Office Of The Head Master GHS Garium (NWTD)

FOR THE MONTH OF 4
_____/______/2020
6
DDO Code 5 6
(Cost Center) Description
Personnel Employee National ID
Number 7 50175051 Name 8 Muhammad Azam Khan S/O Lal Madar Card Number 21505-5723399-7
Salary
BPS 10 17 Designation SET Of Edu/deptt Status
12
Start Stop
GENERAL DATA CHANGE 13 CHANGE IN PAYMENTS / DEDUCTIONS 17
Info 14 Field Wage Amount Effective

Type ID 15 New Contents 16 Type 18 Rupees 19 Paisa Adj Date 21 Remarks 22
20
Due to
completion of 35 Years
Qualifying Service and 60
PAY STOP WEF 7/10/2023 Years Age Mr. Muhammad
Azam Khan Son of Lal Madar
Ex:SET Of Edu/deptt is hereby
retired from the service on
Superannuation Retirement
Pension with effect from // on
his own request.
Head Master GHS

UNDER TAKING
I Mr. Muhammad Azam Khan Son of Lal Madar SET Of Edu/deptt BPS 17
DOB, 01/06/1963 DOA, 20/01/1988 DOR, 31/05/2023 village Mulagan Tehsil Mir Ali CNIC No.
21505-5723399-7 Personal No.50175051 Solemnly Declare that I am proceeding on
Superannuation Retirement with effect from 31/05/2023 there is no outstanding me should be
recovered from my pension and commutation.

CNIC NO. 21505-5723399-7
Attested
Head Master GHS

Head Master GHS

Garium (NWTD)

....... New Retiring Pension 01.07.2023 Muhammad Azam

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2

REAT: 148.4628 110050.00 X 7 X 30 = 77035.00

EP 2010 UPTO 3000/- = 0.00

TOTAL MONTH LEAVE TOT LEAVE

District Accounts Officer,

Subject: Superannuation Retirement Pension Claim In R/O Mr.Muhammad Azam

1. Subject Superannuation Retirement pension claim alongwith orignal Service

2. Servicee particulars of the pensioner are as under:-

a. D.O Birth 6/1/1963

Head Master GHS Head Master GHS

Due to completion of 35 Years Qualifying Service and 60 Years

He is also entitled for 365/- day’s encashment of Leave in lien of L.P.R.

Head Master GHS

No. ______________/Pen Dated _______/_______/2023

1 The District Account Officer NW Miran Shah for Information.

Head Master GHS

KHYBER PAKHTUNKHWA GOVERNMENT GAZETTE, EXTRAORDINARY 06th SEPREMBER, 2021

APPLICATION /CERTIFICATES TO BE GIVEN BY THE PENSIONER FOR

Head Master GHS

That I has retied from Government service. I am due to retire on 31/05/2023. My

(Signature/Left hand thumb impression in r/o)

Head Master GHS

Head Master GHS

DOB: 6/1/1963 Pension 110050 X 7 X 30 = 77035.00

26962.25 X 148.4628 = 4002891

Head Master GHS

Thumb Index Finger Middle Finger Rang Finger Little Finger

Head Master GHS

Head Master GHS

LIST OF FAMILY MEMBERS

S No. Name Relation Age/Birth Marrage/Un Marrage

Head Master GHS

Head Master GHS

(Signature/Left hand thumb impression in r/o)

Head Master GHS Head Master GHS

DECLARATION IN SUPPORT OF PENSION CLAIM

(Signature/Left hand thumb impression in r/o)

Head Master GHS Head Master GHS

(Signature/Left hand thumb impression in r/o)

Head Master GHS Head Master GHS

NON INVOLVEMENT CERTIFICATE.

(Signature/Left hand thumb impression in r/o)

Head Master GHS Head Master GHS

(Signature/Left hand thumb impression in r/o)

Head Master GHS

Head Master GHS

Head Master GHS Head Master GHS

Head Master GHS

Head Master GHS

Head Master GHS

NON PAYMENT CERTIFICATE OF LEAVE DURING LAST 12 MONTHS

Head Master GHS Head Master GHS

Head Master GHS

Head Master GHS

EXTRAORDINARY REGISTERED NO. Rlll

Name: Muhammad Azam Khan

PENSION SANCTION ORDER TO BE USED IN CASE OF

Subject: Sanction of Pension Superannuation Retirement

On attaining the age of superannuation/having applied for retiring/invalid/compensatory

(2) Certified that no inquiry is pending against him/her

Head Master GHS Head Master GHS

5. I hereby undertake to refund if the amount of pension granted to me afterward found to be in

Signature of Muhammad Azam Khan

No. __________/Pen Dated _/_____/2023

Acknowledgement Receipt No._ Signature of Officer