(Refer Para 6.1)

ANNEXURE-VIII

Receipted Bill

 

Part I.

                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…………………………………………………………………………………………………

Designation:………………………………………………………………………………………………………………………

.Name of State on whose cadre borne……………………………………………………………………………………………..

Dated:………………………………..

 

                                                                                                                                            (Revenue Stamp)

 

 

                                                                                                                                                 Signature (s) of Recipient (s)

                                                                                                                                                 (Name in block letters)

 

Part II

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)

 

                                                                                                                          Signature:

                                                                                                                        Date:………………………………….

                                                                                                                        Designation of DDO

                                                                                                                        Government of………………………..               

 

Part III

         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.

 

 

                                                                                                                                        Signature………………………

                                                                                                                                        DDO,DP & AR

 

 

 

Part IV

 

FOR USE IN PAY AND ACCOUNTS OFFICE

 

 

 

                Passed for payment of Rs.……………………………….(Rupees…………………………………………………...)

 

Payment through     Cheque (s) No (s) .. . . ………………………………………………………………….                                               

 

 

 Date……………………..                                                                                                                                 Account Office

 

                 * Delete whichever is inapplicable.