Form No. 8 NOMINATION FOR BENEFITS UNDER THE CENTRAL GOVERNMENT EMPLOYEE'S GROUP INSURANCE SCHEME. 1980. (when the Government Servant has a family and wishes to nominate one member or more than one member thereof.) I ....................... hereby nominate the person (s) mentioned below who is/are member (s) of my family, and confer on him/them the right to receive to the extent specified below any amount that may be sanctioned by the Central Government under the Central Government Employee's Group Insurance Scheme my death while in service of which having become payable on my attaining the age of superannuation may remain unpaid at my death. Sl. No. Name & addresses of Nominee/nominess. Relationship With Govt.Servant. Age Share of Amount be paid each. to to Conting encies On the happeni ng of which the nominati on shall become invalid. Name, address relationship the person, if any, to whom right of the nominee shall pass in the event of his predeceasing the Government servant. 1 2 3 4 5 6 7 1. 2. 3. 4. 5. 6. N. B.:The Government Servant should draw lines across the blank space below his least entry to prevent insertion of any names after he has signed. Dated this ............day of ............19 .........at Signature of two witnesses: Signature of Government Servant. This column should be filled in so as to cover the whole amount that may be payable under the Insurance Scheme.
