Amendment to the Scheme for Payment of Pensions to Central Government Civil Pensioners by Authorized Banks [Fourth Edition, 3rd December, 2004)
(See para 15.1 page 11 of
CPAO’s Scheme Booklet)
Part-A (Every year)
(To be submitted by Pensioner once a year in November)
Certified that I have seen the pensioner Shri/Smt./Ms.
___________________________________ (Name of Pensioner) holder of Pension Payment Order No. _________________________ and that
is alive on this date.
1. Present address of the pensioner/ family pensioner.
2. Telephone/Mobile number (if any).
3. E-mail Address (if any).
Designation of Authorised Officer
Life Certificate of Pensioner/Family Pensioner of Shri/Smt/Ms._______ _____________ _________ _________
(Name of Pensioner)
holder of Pension Payment Order No.___________________ has been received.
Stamp of the receiving Bank branch
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