(Refer Para 6.1)
Received the sum of Rs under the All India Services Group Insurance Rules, 1981, being the total of entitlement of Rs .. from the Insurance Fund and or of Rs . from the Saving Fund, accrued to: Name: . .
Service to which I/he * belonged
.Name of State on whose cadre borne ..
Signature (s) of Recipient (s)
(Name in block letters)
Endorsement to be recorded by the Designated Drawing officer of State/Union Territory or D.D.O.
of concerned Central Ministry/Department in respect of an Officer on deputation to center.
(a) Date on which the Officer become a member of the Scheme
(b) Description of the event (retirement, resignation, death etc.) and date thereof ..
(c) Counter signed for payment of Rs ..(Rupees .)
to claimant (s) Crossed Cheque / demand draft to be issued in favour of claimant(s)
Designation of DDO
Government of ..
Endorsement to be recorded by the DDO Department of personnal and Administrative Reforms certified that the above details (including entitlement under the Saving Fund) have been verified and found to be correct.
DDO,DP & AR
Passed for payment of Rs. .(Rupees ...)
Payment through Cheque (s) No (s) .. . . .
Date .. Account Office
* Delete whichever is inapplicable.