APPLICATION FOR ANNUAL MAINTENANCE GRANT FROM AMALGAMATED FUND TO DISABLED IN ACTION Identity Card No. : NR No. : 1. Number : Rank.: Name: Corps: 2. Unit : 3. Date of Birth 4. Permanent address : 5. Date of Discharge : 6. Percentage of disability : ( Authority to be quoted ) 7. Is it battle casualty as per SAO 8/S/85 : 8. Total emoluments last drawn giving details of Basic Pay Allowance etc. : 9. Amount of war injury pay if sanctioned with Authority : 10. Whether he has been sanctioned ex-gratia : grant by the Govt. of Tamil Nadu 11. Whether the disabled Ex-Servicemen is married and if so the details of children, if any should be furnished as indicated below Name Age with date of birth Sex School in which studying Class in which studying (Academic year also should be noted in bracket) 12. Details of immovable properties if any held like house / lands and annual /monthly income if any from thereon : 13. Whether he is employed as salaried worker or in self employment like business after discharge and if so the details of present emoluments/earnings should be furnished : 14. If he is not employed, whether his name has been registered for Employment : 15. If registered for employment give details. If not registered, reasons therefore may be indicated : SIGNATURE OF DISABLED EX-SERVICEMEN /Attested by/ SECRETARY, DISTRICT SOLDIER'S SAILORS' AND AIRMEN'S BOARD
