ANNEXURE-I PENSIONER'S ANNUAL VERIFICATION CERTIFICATE Pass Port size Photo of the Pensioner 1 Nature of Pension 2 Name of Pensioner 3 S/o, W/o, D/o, Photo of 4 Date of Birth 5 P.P.O.No. 6 Name of Bank 7 Bank Account No 8 Re-employment/employment particulars 8 a Name of the Office 8 b Date of employment /employment 8 c Tenure 8 d Total emoluments drawing 9 Certified that he/she is not drawing any other Pension 10 Certified that he/she is drawing other Pension Through P.P.O.No. 11 Remarriage particulars 11 a Date of remarriage 11 b Name of the spouse 12 Present Residential Address Phone No. Certified that I have seen the above pensioner as on -------------------and he/she is alive on this date. The particulars furnished above are true to the best of my knowledge. Left hand thumb impresion Of the pensioner OR Signed before me (Signature of the Pensioner) Signature of the Treasury Officer STO/ATO/APPO Name and Seal Signature of the Gazetted Officer.