Checklist for Pensioners for proper submission of forms required to be submitted by them prior to Retirement:

All Forms are required to be filled in capital letter in black ball point ink pen without any overwriting or using white fluid. Before commencing writing the pensionary forms CCS Pension Rules may be read in full spirit and same may be scrupulously followed.

Filling up of different forms : 

• Form No. 5 as per CCS Pension rules towards particulars to be obtained by the HOO/Competent Authority from the retiring government servant 08 months before the date of retirement -to be filled correctly and ensure correct enclosures desired in the said Form. 
• Three copies of joint passport size photographs as desired at Sl No: 4 of the Form 5 shall be recent, colour  photograph. 
• As desired at Sl No: 11 of the said Form, in case of 

YES , legible copy of Military Discharge Certificate, Pension Payment Order from Military authority duly attested by HOO/Competent Authority required to be  enclosed. 

In case of NO, copy of UNDERTAKING to be submitted duly countersigned by the HOO/Competent Authority. 

Form No. 3 as per CCS Pension rules towards details of family – 

• to be filled along  with  Date  of  Birth  of  spouse  and  all  other  such  dependant  family members are required to be mentioned. 
• Details regarding daughter/s whether married or not are essentially required to be mentioned.
• Postcard size  group photographs  preferably  with  tagging  of  name  in  duplicate of  all  family members   including   self   is   essentially   required.   
• HOO/Competent Authority concerned,  are required to ensure the correctness of the Date of Birth of all nominees. 

Form A (see rule 5) under Appendix 16 as per CCS Pension rules –

• ensure all the columns are filled correctly. 
• Witnesses are required to mention their name, designation and office in block letters. 
• Under the last column where in the contingencies  on  happening  of  which  nomination  become  invalid-  does  not mention DEATH. 

Form -IA (for commutation of a fraction of superannuation pension without medical  examination-

• as  per  CCS  commutation  of  pension  Rule)  in  case  of superannuation & Form -I (for commutation of a fraction of superannuation pension without medical examination-as per CCS commutation of pension Rule) -in case of Voluntary retirement – to be filled correctly. 

Form -5 (Rule 7) as per CCS commutation of pension Rule towards nomination of  the  CCS (Commutation  of  pension) –

• in  block  letters  and  signature  of witnesses with name, designation and office. 
• Specimen  signature,  thumb  impression,  Descriptive  Roll  in  triplicate – duly attested by gazette officer.
• Format  regarding  bank  details in  case  of  drawal  of  Pension  through  Public Sector  Bank –  also  enclose  the  copy  of  the cover  page  of  the  pass  book mentioning the bank details, i.e.; address of the bank, bank branch name, code, and bank account number, BSR code, etc. 
• Format required to be issued by the concerned Bank from where the pensioner willing to obtain pension. Ensure signature, Branch detail and bank stamp. 

Annexure-II regarding government accommodation –

• applicable portion to be filled by the pensioner and non-applicable portion to be recorded as “NonApplicable”.  
• Same  is  required  to  be  attested  by  the  concerned  HOO/Competent Authority. 

CGHS option-

• duly countersigned by HOO/Competent Authority. 

Entries in Service Book:  Service  verification  certificate  showing  service  book  volume wise/page  wise entry-

• Ensure that the service from the date of entry in government service (including foreign service, which is pensionable) till the date of retirement is found verified. 
• Details of such verification indicating period of service and page no; in service book, to be prepared in a tabulated form in a separate sheet and pasted in service book. 
• Details of EOL (without Medical Certificate, if any) is required to be prepared in a tabulated form in a separate sheet and pasted in service book 
• In case of Dies-non- detail of such period is required to be prepared in a tabulated form in a separate sheet mentioning the period and relevant page of  the service book and pasted in service book. Ensure condonotion certificate by respective HOO/Competent Authority in the service book mentioning that the period of such Dies-non will not amount to break in service in terms of GOI decision 1 under Rule 28 of CCS(Pension),CCS Pension rule 27 and FR 17A. 

Service book & Leave account – ensure completed, updated and duly attested by HOO/Competent Authority on the date of dispatch. In case of MTS officials whose pay was lifted to GP Rs. 1800/- as on 1.1.2006-

Ensure that requisite training certificate is attached with proper entry in the service book.