ANNEXURE-I (Application & Declaration for Drawal of pension through Banks) (As per para 4,1 of G.O.Ms.No.213, F & P (FW.PSC)Dept., Dt.19-12-1997). To The Sub-Treasury Officer(Pension Payment Officer Sir, SUB:- Payment of pensions through Banks-Reg. REF:- G.O.Ms.No.213, Fin.&Plg.(FW.PSC)Dept,Dt.19-12-1997. *** As per the provisions contained in the scheme of payment of pensions through Banks brought into force by the Government Order cited. I request you to credit the amount of my pension through my nominated Bank. I give below the details along with three photos. 1 Name of the Pensioner/Family Pensioner (in capital letters) 2 Name of the Bank 3 Name of the Branch 4 Pension payment Order No. 5 Amount of monthly pension 5 a Pension Rs. 5 b Relief Rs. 6 Saving Bank Account No 7 Life Time arrears and Family Pension Nominee 8 Permanent Postal Address I agree to the conditions regarding giving Annual Certificates as prescribed in the rules. I hereby declare that I and my heirs and successors accept the liability of making good to Government, over payment if any made to me under the scheme. I also agree to undertake that any amount of excess/Wrong payment of pension credited to my above Saving Bank may be recovered or withdrawn from the said Saving Bank by the said Bank. Yours faithfully, SIGNATURE OF THE PENSIONER/ FAMILY PENSIONER.
