SWATANTRATA SAINIK SAMMAN PENSION SCHEME APPLICATION FORM PART- I PERSONAL PARTICULARS 1. Name of Applicant: ____________________________ (In Block Letters) 2. Address: ___________________________ 3. Age of Applicant : ______________________________ (if the applicant is dependent) 4.Name of Freedom Fighter (if the applicant is dependent) ______________________________ 5.Realtionship of the applicant to ______________________________ the Freedom fighters 6.Address of Freedom Fighter ______________________________ 7. Nationality: _____________________________ 8. Occupation: _____________________________ 9. Name of the dependent family _____________________________ members, their age and relationship to the applicant family includes _____________________________ mother, father widower, widow (if she is not remarried) and unmarried _____________________________ daughters. 10. Whether he or she is receiving pension from the State Government ____________________________ under the State Scheme, if so amount
