FORM OF APPLICATION FOR COMMUTATION OF A FRACTION OF SUPERANNUATION PENSION WITHOUT MEDICAL EXAMINATION WHEN APPLICANT DESIRES THAT THE PAYMENT OF THE COMMUTED VALUE OF PEMSION SHOULD BE AUTHORISED THROUGH THE PENSION PAYMENTS ORDER
(To be submitted in duplicate 3 months before the date of retirement)
The Chief Secretary to the Government of U.P.
Subject :- COMMUTATION OF PENSION WITHOUT MEDICAL EXAMINATION
I desire to commute a fraction of my pension in accordance with the provision of the AIS (Commutation of Pension) Regulations 1959.
1. Name in block letters:
2. Father's name (and husband's name in the case of female member of the service)
4. Name of Office/Department/ministry in which posted
5. Date of Birth (by Christian era)
6. Date of retirement on superannuation or on the expiry of
extension in service .
7. Fraction of superannuation person proposed to be
commuted (Maximum amount of pension on that
can be commuted is one third)
8. Disbursing authority from which pension is to be drawn
after retirement . .
(a) Treasury/Sub Treasury (Name and complete address of
the Treasury/Sub-Treasury Office indicated)
(i) Branch of the nationalized bank with complete postal address
(ii) Bank account No. to which monthly S.B.A./No. ...
Pension is to be credited each month
(C) Designation and address of the Account officer.
(Applicable in a case where the pension is proposed to
be drawn through an Account Officer other than the A.O.
issuing the P.P.O.) .
Present Postal address .
Postal address after retirement
NOTE: The payment of commuted value of pension shall be made through the disbursing authority from which pension is to be drawn after retirement. It is not open to an applicant to draw the commuted value of pension from a disbursing authority other than the disbursing authority from which pension is to be drawn.